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Personal Health Information (PHI)

Protected health information is any personal health detail that doctors, hospitals or insurance companies must keep private and safe. This includes details like your name, birthday and medical history.

There are two ways to submit a PHI request:

  • Use our online form to submit your request securely **
  • Download, fill out and mail your request form to us.
Download form

 

** Our digital PHI Release Authorization Form is temporarily unavailable while we perform scheduled maintenance. To submit a request during this time, please download and complete the form and return it to IEHP by mail, fax or email.