Ghering Health & Wellness Center 
 300 Scotland Road
 Edinboro, PA 16444
 814-732-2666 fax
E-mail  Director


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Release of Information Form


For CAPS to release information from your records, authorization by you is required. Please complete the Authorization to Release Information form, sign it yourself and by a witness, then return it to CAPS by fax or U.S. Mail.

You may be contacted if it is necessary to clarify the specific information that you wish to have released.

Questions may be addressed to CAPS' Director using the e-mail link at the left.

Form for Authorization to Release Information