Public Records Request Form


The Center for Health Information and Analysis encourages you to complete the form below to make a public records request (PRR). This helps to ensure the most expeditious and accurate response to your request. Otherwise, written requests may be delivered by hand, mail, email or fax (if available). Please note that certain Nursing Facility and Resident Care Facility Cost Reports are available on CHIA’s website.

While requests for public records may be made orally in person to CHIA's Records Access Officer (RAO), such requests may not be the subject of an appeal. Telephone requests may be accepted at the discretion of the RAO.

If you have any difficulty or have questions regarding the form, please contact:

Email: public.records@chiamass.gov
Phone: (617) 701-8105

Please note: CHIA fulfills public records requests by releasing records in the form in which it is currently held by CHIA. CHIA does not create data, perform individualized analyses, or tailor the format or presentation of data in response to specific inquiries through the public records process. Below is a list of commonly requested records.

* required information

Requestor Information
Please check the type of record(s) you are requesting
Cost Report
Other
To request multiple records, please list records in alphabetical order and specify year (Complete an additional form if necessary):