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\r\n Please keep the below confirmation number for your records:
\r\n {{ confirmationNumber }}\r\n\r\n \r\n The confirmation number is only visible until you close this page.\r\n
\r\nPlease fill out the necessary contact information for the person\r\n whose records you are requesting.
\r\n\r\n\r\n We also need you to enter information for the individual and/or\r\n organization who will be receiving the requested records. This individual will\r\n serve as the point of contact if any questions should arise while fulfilling the\r\n request.\r\n
\r\n \r\n \r\n\r\n Please tell us a little bit more about yourself:\r\n
\r\n\r\n\r\n We encourage you to include an email address and phone number for quicker and\r\n easier communication with the HRSA FOIA office.\r\n
\r\n\r\nFor noncommercial requesters, HRSA may charge only for the actual cost of\r\n searching for records and the cost of making copies. HRSA does not charge a duplication\r\n fee when providing electronic records.
\r\n\r\nHRSA will not charge if the total processing cost is less than $25.\r\n If the total processing cost is estimated to exceed the amount specified below,\r\n HRSA will notify you before proceeding with processing the request.\r\n If a fee waiver is denied, HRSA will contact you to determine if you would like\r\n to proceed with your request.\r\n
\r\n\r\n For more information on processing fees, please read the\r\n FOIA FAQs.\r\n{{ expProcRequestedLabel }}
\r\n\r\n\r\n Please note that requests for personnel records typically fall under the Privacy Act.\r\n The HRSA FOIA Office does not process Privacy Act requests. Please contact the\r\n Privacy Office at PrivacyAct@hrsa.gov\r\n with your request.\r\n
\r\n\r\n Please note that the HRSA FOIA Office is not responsible for Provider Relief Fund\r\n information. Please see the\r\n PRF website\r\n or the HRSA FOIA website\r\n for information concerning PR applications or any other PRF related materials.\r\n
\r\n\r\n Please note that Countermeasures Injury Compensation Program data is available through\r\n the HRSA FOIA Reading Room. Please navigate to\r\n HRSA's CICP Data\r\n page to search for the required records.\r\n If the records you are seeking are not already available, then submit a request\r\n using the \"Non-public records\" option.\r\n
\r\n\r\n Please note that basic contract information (e.g., Award Numbers, Recipients, Date Ranges,\r\n Award Amounts, and Descriptions) is already available on the USASpending.gov website.\r\n Please visit the USASpending.gov website\r\n and search for your desired information on contracts before submitting a FOIA request.\r\n
\r\n\r\n Please note that basic grant information (e.g., Program Area, Fiscal Year, Grant Numbers,\r\n States, Award Amounts, Grantee Contact Details, etc.) is publicly available on HRSA's\r\n website.\r\n Please visit the HRSA Grants Database\r\n and search for your desired information on grants before submitting a FOIA request.\r\n
\r\n{{ recordsTypeLabel }}:
\r\n\r\n\r\n Please provide a description of the type of records you are seeking:\r\n
\r\n\r\n\r\n Please upload a copy of one of the following as proof of identity:\r\n
\r\n\r\n\r\n Please upload one of the following:\r\n
\r\n\r\n{{ requestTypeLabel }}:
\r\n\r\n\r\n Please take a moment to review the records in the\r\n HRSA Reading Room\r\n to determine if the records you might be requesting have already been published.\r\n
\r\n\r\n\r\n If the records you are seeking have not already been published, please use the \"Next\" button\r\n below to begin your FOIA request.\r\n
\r\n\r\n\r\n If you have already submitted a request and would like to check its progress, please access\r\n the
\r\n Please email {{ config.supportEmail }}\r\n and reference the confirmation number if you need to modify or cancel your request.\r\n
\r\n\r\n Thank you for using the FOIA request portal for the Health Resources and Services\r\n Administration!\r\nPlease enter the {{ idName }} and Personal Identification Number (PIN)\r\n that you received in your acknowledgement letter.
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