Your browser does not support JavaScript!
This form cannot automatically check that you have submitted all of the required fields without JavaScript.
Please be sure to submit all required fields (marked with stars).

Curry Health Network

Financials Request

Please complete the following form to request financial statements of Curry Health District.
PLEASE NOTE: Documents will be sent electronically via email.

However, if you wish to receive printed copies, under ORS 192.440 public body may establish fees reasonably calculated to reimburse the public body for the public body's actual cost of making public records available, including costs for summarizing, compiling or tailoring the public records, either in organization or media, to meet the persons request.
* First Name
Your first name
* Last Name
Your last name
* Mailing Address
* City
* State
* Zipcode
* Your Email Address
Enter your email address
* Re-enter your Email Address
* Description of request
Include what month/year, or range (e.g. June through August 2014) for which you are requesting financial documents. Your request can not be processed unless this is complete.