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Womens Care of Bradenton fax number

(941) 500-3113

Medical Records

Used for: Authorization for Release of Medical Records

Fax destination details

Department
Medical Records
Purpose
Authorization for Release of Medical Records
Form
Authorization for Release of Medical Records — Authorization for Release of Medical Records
Address
4216 Cortez Road W, Bradenton, FL 34210
Voice phone
+1-941-500-3100

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.

Authorization to release medical information is valid for 60 days from the date signed; you may revoke in writing; there is a copying fee ($1 per page for the first 15 pages, then $0.25 per page); allow at least 48 hours’ notice for copying of medical records.

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

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