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OrthoNeuro fax number

(614) 818-7724

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Medical Records

Used for: Authorization for Disclosure of Health Information / medical records release

Fax destination details

Department
Medical Records
Purpose
Authorization for Disclosure of Health Information / medical records release
Form
Authorization for Disclosure of Health Information (Medical Records Release Form) — Authorization for Disclosure of Health Information
Address
1313 Olentangy River Rd, Columbus, OH 43212
Voice phone
+1 614-890-6555

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Patient fills required fields (name, date of birth, address, etc.), selects what information to disclose (ER records, progress notes, labs, etc.), specifies recipient, signs and dates, and notes expiration date/event; informs about potential re-disclosure and applicable fees.

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

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