This guide is designed to help you fill out the forms yourself. It is not intended to provide legal advice nor strategy as to how to complete the case.Your request was forwarded to the responsible practitioner for review. We received your request to (change) or correct your protected health information dated:. Forms on this page are always up to date. Clearly state the position you are applying for and where you found the job listing. SAMPLE. Mr. Austin Beutner. Superintendent of Schools. After you've filled out, signed, and dated your Request for Order and any attachments, make 2 copies of the forms and any attachments. Learn how to request a court-appointed attorney for a future hearing in Los Angeles County.