Utsw medical records fax number 2026

1. Click ‘Get Form’ to open the utsw medical records fax number document in the editor.
2. In the top right corner, enter your name, any other names used, address, date of birth (DOB), phone number, and email address.
3. In Patient Notice Section A, select the bubble that best describes the purpose of your request.
4. In Patient Notice Section B, provide details on where and how your records should be sent. Include the name/facility name, attention to, address, city, state, zip code, phone number, email, and importantly, the fax number if you want records sent via fax.
5. Indicate your preferred method for receiving medical records in Patient Notice Section C. Records will default to a CD unless specified otherwise.
6. Complete Sections 1 through 4 by selecting appropriate options for types of records requested and indicating relevant time periods or physician names.
7. Read and acknowledge the Patient Acknowledgement section by printing your name, signing it, and dating it. Remember that electronic signatures are not accepted.

Start using our platform today to easily fill out your utsw medical records fax number form for free!