New York Request for an Individuals Health Information

State:
Multi-State
Control #:
US-3577
Format:
Word; 
Rich Text
Instant download

Description

This form is used by an individual to request access to his or her protected health information. The individual's rights regarding this access are also acknowledged by the individual.

How to fill out Request For An Individuals Health Information?

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FAQ

FOIA Tip No. 9: Writing a Good FOIA Request Part IIBe clear and specific.Make sure your request is reasonable in scope.Provide a date range for records or a date of the event you are researching.Provide accurate titles and full names, and include any news stories discussing the subject of your request.More items...?

When submitting a FOIL request: Be as specific as possible in describing the requested records. Include relevant dates, names and descriptions. Specify where to send the records and how you want them sent (e.g., mail, email or fax).

Unemployment Insurance Records: Unemployment Insurance records and information are confidential under both federal and state law and cannot be released under FOIL unless the Department receives proof of identification, a notarized authorization, or under other circumstances prescribed by law.

Include relevant dates, names, descriptions, etc. See suggested language for a FOIL request from the Committee on Open Government. Specify whether you would like to inspect the records or have copies of the records sent to you. If records are available, specify how you want them sent, i.e., via US mail, e-mail or fax.

When submitting a FOIL request: Be as specific as possible in describing the requested records. Include relevant dates, names, descriptions, etc. Specify whether you would like to inspect the records or have copies of the records sent to you.

Overview. The Freedom of Information Law (FOIL), Article 6 (Sections 84-90) of the New York State Public Officers Law, provides the public right to access records maintained by government agencies with certain exceptions.

The agency is required to respond to the appeal within ten business days of the receipt of the appeal by granting access to the records or fully explaining the reasons for further denial in writing.

According to HIPAA, patients have the right to request their records. Other individuals can also request records on behalf of a patient. These include a parent, legal guardian, patient advocate or caregiver with written permission from the patient.

If the Bureau or Office that is the custodian of the records determines that there are no records responsive to your request, or that one or more of the FOIA exemptions described above applies to the documents you request, your request will be denied in writing.

Notice:Use the Open FOIL NY online form: Agency Code.Mail a written request to: Records Access Office.E-mail a written request to: foil@health.ny.gov.Fax a written request to: (518) 486-9144.Submit a request for records in person:

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New York Request for an Individuals Health Information