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PeaceHealth fax number
(360) 527-9383
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Health Information Management (ROI Services)
Used for: Request for Copy of Protected Health Information (PHI) - Release of Information
Fax destination details
- Department
- Health Information Management (ROI Services)
- Purpose
- Request for Copy of Protected Health Information (PHI) - Release of Information
- Form
- SYS1001 — Request for Copy of Protected Health Information
- Address
- 1115 SE 164th Ave., Dept 336, Vancouver, WA 98683
- 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 SYS1001 with patient details, dates, and delivery method; submit by fax to 360-527-9383, by email to releaseofinfo@peacehealth.org, or by mail to PeaceHealth HIM ROI, 1115 SE 164th Ave., Dept 336, Vancouver, WA 98683. Processing times: 15 business days in Washington; 30 days in Oregon and Alaska.
Official form instructions are published as a downloadable file on the organization's website.
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