Section 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.

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.

Return the request for inspection of records to:

Public Disclosure Office

Health Care Authority

676 Woodland Square Loop S.E.

Post Office Box 42700

Olympia, Washington 98504-2700

[Statutory Authority: RCW 41.05.160, 42.56.040, and 70.02.050. WSR 10-18-051 (Order 10-01), § 182-04-070, filed 8/27/10, effective 9/27/10. Statutory Authority: RCW 41.05.160 and chapter 41.05 RCW. WSR 98-17-063, § 182-04-070, filed 8/17/98, effective 9/17/98. Statutory Authority: RCW 41.05.160. WSR 97-21-125, § 182-04-070, filed 10/21/97, effective 11/21/97; Order 01-77, § 182-04-070, filed 8/26/77.]

RCW 41.05.160, 42.56.040, and 70.02.050. WSR 10-18-051 (Order 10-01), § 182-04-070, filed 8/27/10, effective 9/27/10. Statutory Authority: RCW 41.05.160 and chapter 41.05 RCW. WSR 98-17-063, § 182-04-070, filed 8/17/98, effective 9/17/98. Statutory Authority: RCW 41.05.160. WSR 97-21-125, § 182-04-070, filed 10/21/97, effective 11/21/97; Order 01-77, § 182-04-070, filed 8/26/77.