Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Northeast Missouri Health Council, Inc. before sending sensitive documents. FaxFlow is not affiliated with this organization.

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Northeast Missouri Health Council, Inc. fax number

(660) 395-5048

Macon Family Health

Used for: Medical records / PHI release requests (records to be disclosed to requested recipients; e.g., for referrals, continuity of care, or legal requests).

Fax destination details

Department
Macon Family Health
Purpose
Medical records / PHI release requests (records to be disclosed to requested recipients; e.g., for referrals, continuity of care, or legal requests).
Form
HIPAA Authorization / Authorization to Release Protected Health Information — Authorization to Release Protected Health Information
Address
209 N Missouri St, Macon, MO 63552
Voice phone
660-395-5045

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 patient information, specify the records to release, recipient information (name, address, fax), purpose, date range, and sign/date; the authorization expires when records are released or in 365 days, whichever comes first.

Review official form instructions

Sources and verification

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