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Milton Pediatric Associates LLC fax number

(781) 356-6299

Pediatrics

Used for: Medical records requests / transfer of care

Fax destination details

Department
Pediatrics
Purpose
Medical records requests / transfer of care
Form
PHI disclosure (HIPAA authorization) / Request for Protected Health Information — Request for Protected Health Information
Address
340 Wood Road, Suite 301, Braintree, MA 02184
Voice phone
781-356-6200

Before you send

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  • 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.
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Fill out the patient and recipient details, specify the information to be released (medical records), indicate the reason (transfer of care), and sign/date. Use the form to request PHI from Milton Pediatric Associates LLC for transfer of care.

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