- 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 6/10/22 visit)
- Place the completed authorization form in an envelope and mail to the Medical Records address listed below or fax it to 248-964-8640.
Questions
If you have questions, HIM staff is available Monday - Friday from 8 am - 4 pm:
Beaumont Hospital, Troy
Health Information Management Department
Attn: Correspondence
44201 Dequindre Rd
Troy, MI 48085
248-964-3924
Imaging Pick-Up (appointment recommended)
Area C
44201 Dequindre Rd.
Troy, MI 48085
Phone: 248-964-8603
Fax: 248-964-4133
You can come to Area C to sign an authorization form or pick up copies of images. Please see the Valet attendant and you will be directed to a short term parking area.