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Clinic Liaison Form

  1. COVID-19 chg 041420

  2. The Correctional Health Services (CHS) Clinical Liaison is a non-emergency service for sharing health-related information. During regular business hours, Monday - Friday 8:00 AM - 5:00 PM, your message will be forwarded to clinical staff where the patient is housed for follow-up.

  3. Submitter Information

  4. Patient Information

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