Healthcare Collections, LLC.

PLEASE READ CAREFULLY:

In order to safeguard your privacy we are unable to respond via e-mail. If you would like to be contacted please provide a telephone number where you can be reached.

GoDaddy

Downloads:

ID Theft Affidavit (pdf, 278k)

Please complete the following information

Name:

Street Address:

Address (cont.):

City:

State/Province:

Zip/Postal Code:

Country:

Work Phone:

Home Phone:

E-mail:

HCI Account Number:

Please confirm the nature of your dispute

Do you intend to pay this debt once we validate it?

Please enter any additional comments

This is a communication from a debt collector. This is an attempt to collect a debt, any information obtained will be used for that purpose.