Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Tidelands Health (Georgetown Memorial Hospital and Waccamaw Community Hospital) before sending sensitive documents. FaxFlow is not affiliated with this organization.
Tidelands Health (Georgetown Memorial Hospital and Waccamaw Community Hospital) fax number
(843) 520-8073
Release of Information
Used for: Authorization for Release of Medical Information (ROI) to a designated recipient
Fax destination details
- Department
- Release of Information
- Purpose
- Authorization for Release of Medical Information (ROI) to a designated recipient
- Form
- Authorization for Release of Medical Information — Authorization for Release of Medical Information
- Address
- 606 Black River Road, Georgetown, SC 29440-3304; 4070 Highway 17 Bypass, Murrells Inlet, SC 29576-5033
- Voice phone
- 843-520-8404
- Website
- Visit organization website
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.
Complete patient identifiers, specify what information to release, designate the recipient, and sign/date. The authorization may be withdrawn by the patient as explained in Tidelands Health notices; this form is used to release medical records under HIPAA.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.