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

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Quail Run Behavioral Health fax number

(602) 283-7735

Health Information Management (HIM) / Medical Records

Used for: Authorization for Release of Protected Health Information (ROI) – release of medical records/PHI

Fax destination details

Department
Health Information Management (HIM) / Medical Records
Purpose
Authorization for Release of Protected Health Information (ROI) – release of medical records/PHI
Form
ROI form — Authorization for Release of Protected Health Information
Address
2545 W. Quail Ave, Phoenix, AZ 85027
Voice phone
602-455-5700

Before you send

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  • 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 details, authorize release, specify the records requested, dates, and how to deliver; signer must date.

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

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