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Get the free LI-060-FORM-3Application for Access to PHI. WGH Policy & Procedure

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Application for Access to Personal Health Information About You Last NameFirst Emailing Addressing/TownTerritory/ProvincePostal Code Date of Birth (YYY/mm/dd) Contact Number (Daytime)Contact Number
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The LI-060-Form-3 application is used to request access to specific information or data held by a governmental or regulatory body.
Individuals or organizations that wish to obtain access to certain information or records maintained by a governmental or regulatory agency are required to file the LI-060-Form-3 application.
To fill out the LI-060-Form-3 application, provide accurate personal or organizational information, specify the documents or information requested, and any relevant details that may assist in processing the request.
The purpose of the LI-060-Form-3 application is to facilitate transparency and allow individuals or organizations to access public records or information they are entitled to under law.
The LI-060-Form-3 application must include the applicant's contact information, a detailed description of the requested information, and any other required identifiers or clarifying information.
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