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Instructions for Completing the Confidential Information Form. Complete the entire form and check all that apply.This form and any additional pages must be served on all unrepresented parties and counsel of record. The patient, or patient's legal representative, shall complete and sign the "Request for. Confidential Communications" form (see Attachment A). A Certificate of Confidentiality request must be completed in its entirety in one Internet browser session; you cannot save and finish it later. Note: You must complete the CoC request in one session, as you will not be able to save and return at a later time. Certificate of Confidentiality Request. Note: You must complete the CoC request in one session, as you will not be able to save and return at a later time. Please complete the Confidential Communication Request Form (PDF).