Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Mercy Gilbert Medical Center before sending sensitive documents. FaxFlow is not affiliated with this organization.
Mercy Gilbert Medical Center fax number
(480) 728-9618
Health Information Management / Medical Records
Used for: Medical records request / release of information (ROI)
Fax destination details
- Department
- Health Information Management / Medical Records
- Purpose
- Medical records request / release of information (ROI)
- Form
- Release of Information (ROI) form — Patient's Request for Access to Protected Health Information
- Address
- 3555 S. Val Vista Dr., Gilbert, AZ 85297
- Voice phone
- (480) 728-7103
- 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.
HIPAA-compliant ROI form; specify facility name, date range, type of records, delivery method, and sign/date; submit by mail or fax to the facility's Health Information Management/Medical Records department.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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