Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with UT Southwestern Medical Center (UTSW) before sending sensitive documents. FaxFlow is not affiliated with this organization.
UT Southwestern Medical Center (UTSW) fax number
(214) 645-9141
Health Information Management – Release of Information
Used for: Authorization to Disclose Protected Health Information (PHI) and release of medical records
Fax destination details
- Department
- Health Information Management – Release of Information
- Purpose
- Authorization to Disclose Protected Health Information (PHI) and release of medical records
- Form
- PHI Authorization Form — Authorization to Disclose Protected Health Information (PHI)
- Address
- 5323 Harry Hines Boulevard, Dallas, TX 75390-8525
- Voice phone
- 214-645-3030
- 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.
Instructions for completing the PHI authorization: fill in patient name, DOB, contact info; specify what records to disclose; select delivery method (fax, email, mail, or MyChart); hand-sign; electronic signatures are not accepted; return to Health Information Management; fees may apply as per Texas state guidelines.
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.