IVF Florida Reproductive Associates fax number

Fax destination details

Department

Medical Records Department

Purpose

Medical records release / authorization to disclose health information

Form

Authorization for Use and Disclosure of Health Information — AUTHORIZATION FOR USE AND DISCLOSURE OF HEALTH INFORMATION

Address

7280 W Palmetto Park Rd STE 104, Boca Raton, FL 33433-3401

Voice phone

(954) 247-6200

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.

Sign and date the Authorization for Use and Disclosure of Health Information to permit IVF Florida Reproductive Associates to release identifiable health information. One copy of the medical record will be provided upon written request at no charge; copying fees may apply for larger requests (per Florida rules). Allow 10–14 working days for copying. Complete patient name, date of birth, medical record number (if known), information to be released, recipient, and purpose. Revocation must be in writing and sent to the Medical Records Department at 2960 N State Road 7, Suite 300, Margate, FL 33063.

Official form instructions are published as a downloadable file on the organization's website.