Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with The Urology Group (Tri State Urologic Services PSC, Inc., doing business as The Urology Group) before sending sensitive documents. FaxFlow is not affiliated with this organization.

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The Urology Group (Tri State Urologic Services PSC, Inc., doing business as The Urology Group) fax number

(513) 841-7402

Medical Records

Used for: Medical records requests and PHI release authorizations

Fax destination details

Department
Medical Records
Purpose
Medical records requests and PHI release authorizations
Form
Authorization to Disclose Protected Health Information — Authorization to Disclose Protected Health Information
Address
2000 Joseph E. Sanker Blvd, Cincinnati, OH 45212
Voice phone
513-841-7400

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 patient identifying information, specify the records to release, recipient details, purpose, and consent; then fax to the organization's PHI release number.

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

Sources and verification

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