WAC 182-04-070
Request for inspection of records. The
HCA hereby adopts for use by all persons requesting inspection
and/or copying of its records, the form set out below,
entitled "Request for Inspection of Records."
The information requested in Blocks 4 through 6 is not
mandatory, however, the completion of these blocks will enable
this office to expedite your request and contact you should
the record you seek not be immediately available.
1. Name
4. Phone Number
. . . . . . . . . . . .
2. Address
5. Representing
(if applicable)
. . . . . . . . . . . .
3. Zip Code
6. If urgent -
date needed
. . . . . . . . . . . .
Below please state what record(s) you wish to inspect and be
as specific as possible. If you are uncertain as to the type
or identification of specific record or records we will assist
you.
I certify that the information requested from the above
record(s) will not be part of a list of individuals to be used
for commercial purposes.