Directory information — verify before you send. This fax number was compiled by automated research from public sources. It may be out of date, incomplete, incorrect, or in rare cases wrong entirely, and it is not confirmed by Southeast Orthopedic Specialists. Before sending anything sensitive, confirm the number and receiving department directly with Southeast Orthopedic Specialists, and consider sending a test cover page first. FaxFlow is an independent directory, is not affiliated with, endorsed by, or sponsored by this organization, and accepts no liability for reliance on this listing.
This appears to be a healthcare destination. Faxes here may contain protected health information (PHI), and a misdirected medical fax can be a reportable privacy breach. Confirm the current number and department with the provider — and send a test page — before transmitting any records.
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Southeast Orthopedic Specialists fax number
(904) 634-0203
Wrong or outdated? Report this number
Medical Records / Release of Information
Used for: Medical records release / authorization to disclose health information
Fax destination details
- Department
- Medical Records / Release of Information
- Purpose
- Medical records release / authorization to disclose health information
- Form
- Authorization to Disclose Health Information — Authorization to Disclose Health Information
- Address
- 6800 Southpoint Pkwy, Suite 300, Jacksonville, FL 32216
- Voice phone
- 904-634-0640
- 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 patient information; indicate whether information is being released to a recipient or requested from another facility; provide name/facility, address, phone, and fax for the recipient; specify the purpose; select the records to release (e.g., chart summary, office visit notes, imaging, entire medical record); choose form of records (paper, CD, or eDelivery); sign and date. The authorization expires 12 months from the date signed.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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