SSM Health Good Samaritan Hospital, Mt. Vernon: HIM Department
Requests for copies or release of the records held by this office.
Find SSM Health records faxes for Illinois, Missouri, Oklahoma and Wisconsin facilities.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Requests for copies or release of the records held by this office.
Signed requests for records held by this hospital, clinic or care service.
Match the treatment location and region. The Wisconsin Health Information route groups the facilities named in its entry; hospitals in other regions have their own destinations. A hospital records office may differ from a physician practice’s office.
Complete the authorization linked for the relevant region. Identify the hospital or practice, treatment dates, records requested and delivery recipient, and follow its signature requirements.
Name the receiving department and the hospital, clinic or service involved. Add the document title, page count and a callback number. Put patient identifiers and authorization details in the fields the official form requests; a cover page does not replace signed consent.
Open the official source above and check the current instructions. A reviewed source confirms a published number, not live availability. Toll-free numbers can still incur sending-service or international charges.
Keep the transmission result and a copy of the documents. Confirm with the receiving department that the packet is complete and can be processed; a delivery receipt does not establish acceptance or a decision. These are fax destinations, not voice support lines. Check with SSM Health before sending a duplicate.
Prepare a legible PDF, confirm the department and number, and review all pages before authorizing the fax. With DearFax, you can send online or prepare a workflow through ChatGPT, Codex and MCP. Save the transmission result with your records.
Healthcare organizations should confirm their compliance requirements before selecting a fax service. DearFax does not currently offer HIPAA compliance.
Frequently asked questions