Permission to Share Information Form

Use this form if you want MassHealth to share the information we have about you with another person or organization.

• MassHealth Permission to Share Information (PSI) Form [English] (PDF) 
• MassHealth Permission to Share Information (PSI) Form Large Print [English] 
• MassHealth Formulario de autorización para compartir información (PSI) 

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This information is provided by MassHealth.