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Salem Clinic fax number

(503) 361-3780

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Health Information Management / Medical Records

Used for: Medical records release and Release of Information (ROI) requests

Fax destination details

Department
Health Information Management / Medical Records
Purpose
Medical records release and Release of Information (ROI) requests
Form
Release of Information (ROI) — Release of Information (ROI) form
Address
2020 Capitol Street NE, Salem, OR 97301
Voice phone
503-375-7407

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 the ROI form with patient demographics, purpose, type of information, timeframe, format/delivery, and signatures; ROI is typically valid for 180 days; include recipient information; contact Health Information Management for help at 503-375-7407.

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

Sources and verification

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