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Please note: If you are experiencing a medical emergency, please call 911. If you are experiencing a mental health crisis, please call your local community mental health crisis line. Mental Health Center Greater Manchester crisis line is (800) 688 3544.

Please note: This form is not HIPAA protected, so please keep that in mind when filling out the comment section. We are typically able to respond to requests within 3-4 business days during the business week.