The is the standard Release of Information Form for the Georgia PHP. This form must be completed prior to us discussing your care with an outside party.
Georgia Professionals Health Program, Inc.
4780 Ashford Dunwoody Rd, Ste 540 #393
Atlanta, Georgia 30338-5504 USA
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(678) 825-3764
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(855) 694-2747
Fax: (855)-781-4082
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