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Data Requests

Law Enforcement Request Form

Law Enforcement officials may request data by completing and submitting a request form. Please include, with the completed request form, only the valid search warrant.  Send to the PMP office by fax or email for processing.

Individual Report Request Form

An individual may request a copy of their own prescription history report by completing and submitting a request form. All forms must be signed in the presence of a notary public and submitted to the PMP office by mail, fax or email for processing.

Third Party Release of Information Form

An indivdual may request a copy of their own prescription history report be sent to a third party by completing a request form.  All forms must be signed in the presence of a notary public and submitted to the PMP office by mail, fax or email for processing.