Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Holy Name Medical Center before sending sensitive documents. FaxFlow is not affiliated with this organization.
Holy Name Medical Center fax number
(201) 833-7138
Medical Records
Used for: Medical records request (copies of medical records / release of information)
Fax destination details
- Department
- Medical Records
- Purpose
- Medical records request (copies of medical records / release of information)
- Form
- Authorization for Release of Medical Information — Authorization for Release of Medical Information Form
- Address
- Holy Name Medical Center, 718 Teaneck Road, Teaneck, NJ 07666, USA
- Voice phone
- 201-833-3000
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill out the Authorization for Release of Medical Information with patient details, dates of treatment, and purpose for release; sign; attach required documents. Submit by fax to 201-833-7138, by mail, or in person as directed.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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No public source link was saved with this record. Confirm the number directly with the organization before using it.