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The Urgency Room fax number

(651) 789-9901

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Health Information / ROI (Record Requests)

Used for: Medical records request submission (fax-based) to The Urgency Room's ROI/Records Release

Fax destination details

Department
Health Information / ROI (Record Requests)
Purpose
Medical records request submission (fax-based) to The Urgency Room's ROI/Records Release
Form
Patient access for health information form — Patient access for health information form
Address
4300 MarketPointe Drive, Suite 100, Bloomington, MN 55435
Voice phone
651-789-9951

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.

Download and complete the form, select the documents to release, specify delivery method, sign and date; fax to 651-789-9901 or mail to The Urgency Room, Attn: Health Information/ROI, 4300 MarketPointe Drive, Suite 100, Bloomington, MN 55435.

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

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