Public Records Request Form and Instructions
Please complete CHIA's
Public Record Request Form (PDF) 
|
Word 
to facilitate your request.
You may submit your request in the following ways:
- Email the form to public.records@state.ma.us
- Fax the form to 617-727-7662
- Mail the form to
CHIA Public Records
The Center for Health Information and Analysis
2 Boylston Street, 5th floor
Boston, MA 02116-4734
Please note there is a fee of $.20/per copied page. You will be notified if the charge for your request exceeds $25.00. If you have other public records questions, please contact the Center's Help Desk at 1-800-609-7232.
Case Mix Datasets Request Application and Instructions
Please complete the CHIA Case Mix Datasets Request Application (PDF)
to facilitate your request. You should also review the General Information and Fees (PDF)
You may submit your request in the following ways:
- Email the application to public.records@state.ma.us
- Fax the application to 617-727-7662 - Attention: Data Protection Committee
- Mail the application to:
CHIA Public Records
The Center for Health Information and Analysis
2 Boylston Street, 5th floor
Boston, MA 02116-4734
For questions about the application or the process, please contact CHIA's Help Desk at 1-800-609-7232.