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RELEASE OF INFORMATION FORM PLEASE MAIL OR FAX COMPLETED FORM TO: Take Care Health Systems, LLC Attn: PSC ROI Department 4165 30th Avenue SW, Suite 101, Fargo ND 58104 Phone: 866.825.3227 Fax: 701.277.0352
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Take Care Health Systems is a network of convenient healthcare clinics located within pharmacies.
Employees or individuals who have received healthcare services from Take Care Health Systems may be required to file certain forms for tax or insurance purposes.
You can fill out Take Care Health Systems forms online through their website or in person at one of their clinic locations.
The purpose of Take Care Health Systems is to provide accessible and affordable healthcare services to individuals in need.
Information such as patient demographics, medical history, treatments received, and insurance information may need to be reported on Take Care Health Systems forms.
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