Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Gosnold Treatment Center (Gosnold MID Program / Gosnold at Cataumet / Gosnold Counseling Center) before sending sensitive documents. FaxFlow is not affiliated with this organization.
Gosnold Treatment Center (Gosnold MID Program / Gosnold at Cataumet / Gosnold Counseling Center) fax number
(508) 564-9518
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.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
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.
Sources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.