- Download, print and complete the authorization form
- Complete all highlighted areas. Be sure to specify the dates of service and type of information needed (i.e., ER report from 6/10/06 visit)
- Place the completed authorization form in an envelope and mail to Medical Records address listed below or fax 248-964-2030.
Questions
If you have questions, please contact our Medical Record correspondence clerk at:
Beaumont Hospital, Troy
Health Information Management Department
Attn: Correspondence
44201 Dequindre Rd
Troy, MI 48085
248-964-3924
Imaging Pick-Up
Area C, Suite 118
44201 Dequindre Rd.
Troy, MI 48085
Phone: 248-964-8603
Fax: 248-964-8640
You can come to Area C, Suite 118 to sign an authorization form or pick up copies of records. They should see the Valet attendant and will be directed to a short term parking area.