Records Request

FOR CLIENTS

To request medical records for a client of SAGE Counseling, we provide the following procedure:

Medical records approved for release are provided at no cost.

Name(Required)

First Last

Phone

Please indicate the best time to reach you between the hours of 8:30AM and 5:30PM, Monday through Friday.(Required)

Enter Email Confirm Email

How can we help you?(Required)

Check all that apply and the appropriate departments will be contacted

Schedule an Assessment

Question(s) about my appointment

Tech support question

I need help with AHCCCS

I need to request records

Provide details(Required)

Please let us know how you were referred and the best time to contact you as well as any other relevant information.

Upload Police Reports or Court Paperwork

Drop files here or

Max. file size: 100 MB.

Upload a Release of Information(Required)

Drop files here or

Max. file size: 100 MB.

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