Incarcerated Individual Advocacy Email Request Incarcerated Individual Advocacy Email Request Incarcerated Individual Advocacy Email Request VitalCore wants to thank you for your correspondence and advocating on behalf of a currently incarcerated individual. VitalCore takes the health and safety of our patients seriously and will work diligently to address the concerns or inquiries you have raised.As we work to address the matter that brought you to our website , please help us to better serve you by providing us with some crucial demographic information about the resident. Name (First & Last)(Required) Identification number, if known, or date of birth.(Required) Location of the resident. (Please include the name of the facility and location.)(Required) Please provide your contact information as the resident’s advocate.First & Last Name(Required) Contact Information(Required) Relationship to the resident(Required) Has the resident signed a “release of protected health information” form that enables us to provide the requested information? Yes No CAPTCHA
