Formal Freedom of Information Request

Print out the Request for Access to Information and Correction form.

The Request for Access to Information and Correction form will load in a new tab/window. To print the form, click on the print icon at the bottom of the screen. If the print icon isn't showing, move your mouse pointer to the bottom centre of the screen and it should appear. Once you have finished printing the form, you may close the tab/window containing the form to return to these instructions.

Informal Access to Records

Many records of public institutions are available to you without making a request under the Freedom of Information and Protection of Privacy Act. Contact the Freedom of Information and Privacy (FOIP) Coordinator at the institution that holds the records to determine whether you need to make a formal request.

Type of Request

Check the box that indicates what you are requesting (records that do not contain personal information are general records). The FOIP Coordinator is required to verify your identity before giving you access to your own personal information. If you are requesting another person’s personal information records, you must provide proof that you have the authority to act for them (e.g., power of attorney, guardian, or trusteeship order).

Requestor's Information

Please ensure you have entered your name, address, and telephone numbers accurately.

Description of Records or Correction Required

Provide as much detail as possible about the requested general records, own personal information, or other’s personal information. Use a separate sheet of paper if you need more space and attach it to this form.

If you are requesting personal information records, provide the name that should appear on them.

Check a box to indicate whether you want to examine original documents (which may only be done on-site) or receive copies.

Payment and Signature

A $5 application fee is required.
Make cheques payable to Hôpital de Mattawa Hospital.

Sign and date the form and mail it or submit it in person to the institution that holds the records.

Hôpital de Mattawa Hospital
Attention: Administration Office
P.O. Box 70
217 Turcotte Park Road
Mattawa ON    P0H 1V0

Hôpital de Mattawa Hospital
217 Turcotte Park Road
P.O. Box 70
Mattawa, Ontario P0H 1V0
Tel: 705-744-5511
Fax: 705-744-6020
admin@mattawahospital.ca
Copyright © 2017 Hôpital de Mattawa Hospital Designed & Maintained by VS Group