Clinical Records Request
Please contact us to have a copy of patient records transferred to another provider.
By submitting this form, I agree to be contacted by Fora Health Treatment and Recovery at the phone number or email provided. I authorize Fora Health to leave messages for me including Fora Health’s name, the return caller’s name, and contact information. I understand that in so doing, Fora Health cannot protect this information and that others with access to my electronic equipment (e.g., phone, answering machine; cell phone or computer) could have access to this message. We do not share this information with any outside organizations.