Forms

1. How to Request Records/How to Request an Accounting of Disclosure:
   Authorization to Disclose Form
2. How to Request an Amendment:
   Request for Amendment Form
3. How to Request a Restriction:
   Request for Restriction Form
4. How to Request a Revocation of a Restriction: A request in writing will need to be submitted stating that you would like to revoke the authorization. You will need to list the date of the authorization within the request.