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Stormont Vail Health fax number

(785) 354-5119

Medical Records / Health Information Management

Used for: Medical records requests and authorization to disclose health information

Fax destination details

Department
Medical Records / Health Information Management
Purpose
Medical records requests and authorization to disclose health information
Form
HIPAA Authorization — Authorization To Obtain/Disclose Health Information
Address
1500 SW 10th Ave, Topeka, KS 66604, United States
Voice phone
785-354-6000

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 in patient information, describe the records to be disclosed, and sign the authorization; fax to the hospital’s Medical Records/HIM department at 785-354-5119.

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

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