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FROM / / THROUGH / / PART D RECORD FORMAT Please indicate the format you would like to receive the records in Paper Electronic encrypted CD or DVD PART E DELIVERY METHOD Pick up all my communications at an HMSA office Check one HMSA Center Oahu Hilo Office Kona Office Maui Office The records will be available to you for pickup at one of our HMSA Customer Relations offices. Continued on next page IPP-PO-04 Information Protection and Privacy 06/16 Page 1 of 2 PART F YOUR INDIVIDUAL RIGHTS I...

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Request for copies of is a formal submission to obtain copies of specific documents or records.

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The purpose of a request for copies of is to obtain official copies of documents or records for various reasons such as legal proceedings, research, or personal records keeping.

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