Release of Information Form
Providing Information to Your Care Team
If you need to provide information to a member of your care team or would like us to share information with another provider, please complete our release of information form below.
Excelsior Wellness Portal is live as of July 7. You will receive an email to register. Download the app and view instructions here.
If you need to provide information to a member of your care team or would like us to share information with another provider, please complete our release of information form below.