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Texas Oncology Surgical Specialists - Baylor Charles A. Sammons Cancer Center fax number

(214) 828-2089

Surgical Specialists

Used for: Medical records requests and disclosures (HIPAA authorization to disclose protected health information).

Fax destination details

Department
Surgical Specialists
Purpose
Medical records requests and disclosures (HIPAA authorization to disclose protected health information).
Form
HIPAA release form — Authorization To Disclose Protected Health Information (English/Spanish)
Address
3410 Worth Street, Suite 160, Dallas, TX 75246

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 out the HIPAA release form to authorize the disclosure of protected health information to a named recipient.

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

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