Directory information — verify before you send. This fax number was compiled by automated research from public sources. It may be out of date, incomplete, incorrect, or in rare cases wrong entirely, and it is not confirmed by Gosnold Treatment Center (Gosnold MID Program / Gosnold at Cataumet / Gosnold Counseling Center). Before sending anything sensitive, confirm the number and receiving department directly with Gosnold Treatment Center (Gosnold MID Program / Gosnold at Cataumet / Gosnold Counseling Center), and consider sending a test cover page first. FaxFlow is an independent directory, is not affiliated with, endorsed by, or sponsored by this organization, and accepts no liability for reliance on this listing.
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Gosnold Treatment Center (Gosnold MID Program / Gosnold at Cataumet / Gosnold Counseling Center) fax number
(508) 564-9518
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Intake/Admissions (MID Program – Massachusetts Impaired Drivers Program / Probation liaison)
Used for: Authorization to Exchange Client Information form used to release or obtain patient records for treatment, often in the context of the MID program or probation.
Fax destination details
- Department
- Intake/Admissions (MID Program – Massachusetts Impaired Drivers Program / Probation liaison)
- Purpose
- Authorization to Exchange Client Information form used to release or obtain patient records for treatment, often in the context of the MID program or probation.
- Form
- Authorization to Exchange Client Information — MID Program Authorization to Exchange Client Information
- Address
- 200 Ter Heun Drive, Falmouth, MA 02540
- Voice phone
- 508-540-6550
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
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Fill patient details, indicate whether releasing or obtaining information, specify recipients, purpose, and records to be released; sign and date; submit with correspondence.
Official form instructions are published as a downloadable file on the organization's website.
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