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South Sound Radiology fax number

(360) 493-4614

Medical Records / Health Information Management

Used for: Medical records release / records request for radiology reports and images

Fax destination details

Department
Medical Records / Health Information Management
Purpose
Medical records release / records request for radiology reports and images
Form
Authorization to Release Medical Information — Authorization to Release Medical Information
Address
3417 Ensign Rd NE, Olympia, WA 98506-5075
Voice phone
360-252-9301

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 DOB, indicate delivery method (pickup, email, or send to recipient), provide recipient name/address, select information to disclose (Radiology Report Only or Both Images and Report), specify exam type and dates of service, sign and date.

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

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