Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Provider1st before sending sensitive documents. FaxFlow is not affiliated with this organization.
Provider1st fax number
(855) 514-2378
Release of Information (ROI)
Used for: Processing medical records requests and transferring records for partner healthcare providers (ROI service).
Fax destination details
- Department
- Release of Information (ROI)
- Purpose
- Processing medical records requests and transferring records for partner healthcare providers (ROI service).
- Form
- HIPAA Authorization — Authorization to Disclose Protected Health Information
- Address
- 3161 Michelson Dr. Suite 910, Irvine, CA 92612
- Voice phone
- +1 855-514-2378
- 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.
Fill patient name and birthdate, specify the facility/physician, indicate the records to disclose, select delivery method, sign and date, then submit via fax to 800-818-2114 or email to requests@provider1st.com.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.