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Wellfound Behavioral Health Hospital fax number

(253) 301-5446

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Health Information Management (HIM) / Medical Records

Used for: Medical records release / Release of Information (ROI) requests

Fax destination details

Department
Health Information Management (HIM) / Medical Records
Purpose
Medical records release / Release of Information (ROI) requests
Form
Release of Information Authorization — Release of Information Authorization Form
Address
3402 South 19th Street, Tacoma, WA 98405
Voice phone
253-301-5447

Before you send

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  • 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 the ROI form with patient details, purpose (continuity of care by default), and specific information to disclose. Indicate release format, who to release to, and where to send. Include patient name, DOB, address, phone, and signature. The form must be signed and dated; expiration is typically 1 year unless otherwise specified. A copy or fax of the form is valid in lieu of the original; fees may apply for copies per state regulations.

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

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