With this form you can send a message to
a patient currently at JCHC.
The message will then be delivered by our Social Services Staff.
Attention:
Anything put on this form should not be considered confidential.
Do not put anything in this form you would not put on a postcard.
If you need to discuss private matters please do not use this form.
Your Name
Patient Name
Message
Send mail to
andy.rhine@jchc.us with
questions or comments about this web site.
Last modified:
May 13, 2008
