Newport Hospital fax number

Fax destination details

Department

Health Information Management Department

Purpose

Authorization to Obtain Protected Health Information (PHI); used to request or release medical records from Newport Hospital.

Form

Authorization to Obtain Protected Health Information (PHI) — Authorization to Obtain Protected Health Information

Address

Newport Hospital Health Information Management Department, 11 Friendship Street, Newport, RI 02840

Voice phone

401-845-1150

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.

Complete the PHI authorization form with patient details, the source or recipient of the records, date range, and purpose for disclosure; sign and date. The form may specify what information is being disclosed and may include a statement about confidentiality. The authorization typically expires 1 year from the date signed unless otherwise noted.

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