Records Request Form

Records Request Form

This Records Request is to be used ONLY to request records from Crossnore Communities for Children.

If you need records from Marjorie Williams Academy, please contact the Academy at (828) 733-5241 or by fax at (828) 737-7915.

  • MM slash DD slash YYYY
  • Please upload Release of Information Consent or Proof of Identity (birth certificate or driver's license/state ID) for your request to be completed.
    Drop files here or
    Accepted file types: jpg, png, pdf, Max. file size: 50 MB.
    • Crossnore does not release any 3rd Party documents (documents obtained from external agencies during the course of services) or Psychotherapy Notes.