STEP ONE – Gather Information
- First and last name patient/client
- Last four SSN of patient/client
- What information you are requesting regarding the patient/client
- Facility / office name
- Facility / office address
- Facility / office phone number
- Facility / office fax number
- Facility / office email address
- Facility / office contact person
- Confirmation that facility will agree with request / time frame
- Patient / client first name
- Patient / client last name
- Patient / client last four digits of SSN
- Relationship of requester of patient/client
- Payment Information – We except all major credit cards.
STEP TWO – Pay Online
- We except all major credit cards.
- Start by clicking the Begin Button.
- Follow the prompts and enter in the correct information.
- On the confirmation page click on the FAX SERVICE button.
STEP THREE – Complete Data Request
- Complete the data requested to send out the fax. (This is the information you gathered before starting.)
- Click on the Submit Button. (This will process your request, sending the request to the entity that has the information.)
STEP FOUR – Check your email to receive your receipt and confirmation.