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Please complete the form below. You may also call us at (855) CHS-4500 (855-247-4500) on weekdays, 9 a.m.-7 p.m. Please call 9-1-1 if this is a medical emergency.

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Call (855) CHS-4500 (855-247-4500), Monday - Friday, 9 a.m. to 7 p.m. to speak to a physician referral specialist.