Please Note:
When you submit this form, your message will be sent to the recipient by email. Please allow 1–2 business days for a response. If you need a faster reply, call or text the recipient directly.
If you are trying to contact a medical provider or medical staff about any personal health information, please do not use this form. This form is not secure or HIPAA-protected and should not be used to share details such as:
- Medical symptoms or conditions
- Test results or imaging reports
- Medication refills or changes
- Lab orders or follow-up instructions
- Diagnosis questions or treatment recommendations
- Insurance, billing, or referral details that include personal health information
- Any other information that could identify you in connection with your medical care
For these matters, please use your Elation Patient Passport to send a secure message to your provider.