Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Valley Professionals Community Health Center before sending sensitive documents. FaxFlow is not affiliated with this organization.

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Valley Professionals Community Health Center fax number

(888) 291-5750

Behavioral Health

Used for: Behavioral health records release / Release of Information (ROI) requests

Fax destination details

Department
Behavioral Health
Purpose
Behavioral health records release / Release of Information (ROI) requests
Form
Behavioral Health Release of Information (BH-ROI)
Address
1530 N 7th St Ste 201, Terre Haute, IN 47807, United States
Voice phone
+1 812-238-7631

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, specify which behavioral health records to release, purpose, and expiration; sign and date the form; submit to the VPCHC ROI contact.

Official form instructions are published as a downloadable file on the organization's website.

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