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Surgical Park Center (PHI/ROI Release of Information service) fax number

(844) 481-0298

Release of Information / Medical Records (PHI)

Used for: PHI release via fax; submission of medical records release requests

Fax destination details

Department
Release of Information / Medical Records (PHI)
Purpose
PHI release via fax; submission of medical records release requests
Form
Authorization for Release of PHI — Authorization for Release of PHI (PHI Release Authorization)
Address
Mailing Address: PO Box 290789, Nashville, TN 37229-0789
Voice phone
844-481-0278

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Fill out patient name, recipient name, date of birth, dates of service, facility names, and delivery method; fax to the number.

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