Request a Printed Copy of the Provider Directory

Please fill out and submit the following form to receive a printed copy of the provider directory in the mail. Required fields are labeled with an *.

Which Directory?:   *
Your Information
First Name: *
Last Name: *
Address 1: *
Address 2:
City: * State: * Zip: *
Phone:
Email:
Who Are You?: 
You may also request a printed copy of the provider directory via:
  • email: directoryinfo@chgsd.com
  • phone: 1-800-224-7766
  • or mail:
       2420 Fenton St., Suite 100
       Chula Vista, CA 91914
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