Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Southeast Orthopedic Specialists before sending sensitive documents. FaxFlow is not affiliated with this organization.
Southeast Orthopedic Specialists fax number
(904) 634-0203
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
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.