Request for Telehealth Services

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PLEASE NOTE:

 

  • If this is an emergency, please call 911, or, if able to do so safely, get yourself to the Emergency Room of your nearest hospital.

  • Optionally, you may wish to call an appropriate local Crisis Line.

  • This request for telehealth services is not intended to be used as an emergency response to a mental health or other crisis.

Telehealth Service Request

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