Please note the following before submitting your request:
For immediate assistance with a mental health or substance use crisis, please do not complete the below form. Contact our 24/7 Crisis Line, 866.260.8000. If this is a life-threatening event, please contact 9-1-1
For Medical Records Request, please click here; Please download and complete the Release of Protected Health Information form and attach with your Medical Record Request, NTBHA Release Of Information
For Public Information/Open Records Request, please click here.
Submit Employment Verification requests to, employmentverifications@ntbha.org. Please allow 24 hours for processing.
For complaints/grievances and/or patient rights concerns, please contact our Quality Management (QM) line at 833-392-4800. You may also send an email to info@ntbha.org to address your concerns or select the “Complaint/Grievance/Patient Rights” option in the below form. Someone from our Quality Management department will call you back to address your issue.