Get Fipp Request For Access To Personal Health Records - Ih #827025

Accessing your personal health records is an important step in managing your health information. Filling out the FIPP Request For Access To Personal Health Records - IH #827025 online is straightforward, and this guide will help you navigate each section effectively.

Follow the steps to complete your request online.

1. Press the ‘Get Form’ button to retrieve the form and open it in your preferred editor.
2. Enter your name in the format of First/Middle/Last as requested.
3. Provide your complete mailing address, ensuring to include City/Town, Province, Country, and Postal Code.
4. Fill in your date of birth using the format dd/mm/yyyy to ensure accuracy.
5. Input your Personal Health Number (PHN) or Care Card Number for identification.
6. List your daytime phone number for contact purposes.
7. Include an alternate phone number in case you cannot be reached at your daytime number.
8. Clearly describe the records you are requesting, identifying the IHA Facility that holds the records and the reason for your request. Be specific, and attach a separate sheet if necessary.
9. Indicate whether you are requesting access to another person’s personal information by selecting ‘Yes’ or ‘No’. If you choose ‘Yes,’ attach the appropriate signed consent or proof of authority.
10. Select your preferred method of delivery for the requested records — either by mail or pick up.
11. Provide the name of the individual who will receive the information.
12. Sign the form in the section marked ‘Requestor’s Signature.’
13. Enter the date you are signing the form in dd/mm/yyyy format.
14. Input the complete mailing address of the requester again, along with their contact number.
15. Once all fields are completed, save your changes, and choose to download, print, or share the form as necessary.

Start your health records request online today!