Under certain circumstances, you may request to have your home address, home telephone number, place of employment, and place of education exempt from public records disclosure.
- This page, How to request health profession license information confidentiality, is offered by
- Bureau of Health Professions Licensure
- Department of Public Health
How to request health profession license information confidentiality
Contacts
Bureau of Health Professions Licensure
The Details
What you need
You have the right to keep your information confidential as a victim of domestic violence, victim of an adjudicated crime, or as a provider of services and/or training in family planning.
Beginning on March 6th, 2025, applications to exempt certain information associated with your health profession license from public records requests can be submitted online at https://www.mass.gov/how-to/request-health-profession-license-information-confidentiality-benefits.
Online submissions will be processed in the order in which they are received and are typically completed within 4-6 weeks of receipt of application.
How to request
Go to the Health Professions Licensing Portal and create an account, or log into your existing account. If this is your first time using this new portal, please visit Health Professions Licensing System User Guide).
Downloads
Open PDF file, 157.06 KB,
Public Record Exemption Declaration Form
(English, PDF 157.06 KB)
Open DOCX file, 39.23 KB,
Public Record Exemption Declaration Form
(English, DOCX 39.23 KB)
Contact
Address
250 Washington St., Boston, MA 02108
Phone
Fax
(617) 973-0980