Blue Sky Counseling (207) 616-0705

 **Please specify type of information requested, including specific dates.

Please submit a request for records in writing that includes the timeframe of the records, the specific information being requested, and the names the record may be under during that timeframe to:

1. Print and fill-out the release of information form completely OR complete the online form:  

  Printable: Authorization to Release Confidential Information.docx 

     Online form: Blank Authorization to Release Confidential Information

2. Fax to 207-614-8009 or email to

       To inquire about a submitted request, contact Julie at 207-616-0705 ext.1502

**There may be a charge for records.**