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Public Record Request Portal
1
Check if the information is already online.
Before submitting a request, check this list of available information to ensure it isn't already online.
2
Understand the Request Process.
Read about the public request process and any rules, requirements, and constraints below.
3
Submit your
request.
Click the button below to create a new request.
About the Public Record Request Form
The Arizona Department of Health Services (ADHS) is required by the Arizona's Public Records Law under the Arizona Revised Statute Title 39 to make records available for disclosure. The above form is for those specific requests. Please provide the following information to have your request processed by ADHS's Administrative Counsel and Rules Office. If you have any issues or questions regarding this form, please email [email protected]. If you need assistance completing this form, please see our user guide for help.
If you are seeking data, please see our Data Request webpage regarding publicly available data, and information to request additional data that is not already available in our table.
Who should complete this form?
Public, Law Offices, News Media, Facilities staff, Providers ADHS license
How long will this take?
This form will take approximately 3-5 minutes to complete.
What do I need to complete the form?
Facility or licensee information such as name, address, facility ID
Complaint ID number
Date of complaint, survey, investigation, etc.
ADHS-related program
