FOIL Requests

First Name: *

Last Name: *

Street Address: *

City: *

State: *

Zip Code: *

Primary Phone: *

Daytime telephone number at which you may be reached regarding this request.

I am requesting to inspect or copy the following documents possessed by Roswell Park Cancer Institute pursuant to FOIL (please provide as much detail as possible): *

The purpose of my request is (optional):

Request Preference: *

I prefer to inspect the requested records at RPCI and am not requesting a copy be produced to me at my cost at this time.

I prefer a copy of the requested records and agree to pay the costs, if any, associated with the copy at twenty-five (.25) cents per page. I understand that I will be contacted by RPCI in advance with an estimated cost of preparing a copy of the requested record should it require more than two hours of an employee’s time to copy or should it be necessary to retain an outside professional service to prepare a copy of the record.

MUST CHECK BOXES BELOW BEFORE SUBMITTING REQUEST: *

I have read the rules on fees associated with my request and agree to pay RPCI any such fees should they be required to obtain a copy of the requested records.

I understand that I will be contacted by RPCI with an estimated cost of preparing a copy of the requested record should it require more than two hours of an employee’s time to copy or should it be necessary to retain an outside professional service to prepare a copy of the record.

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Patients

Research & Education

Giving

Careers

Media

Roswell Park

Cancer Talk

FOIL Requests

Public Notices

All Cancer Types

Care Centers & Services

Request An Appointment

Ask A Question

Find A Physician

Address & Directions

Patients

Research & Education

Get Involved

Roswell Park

Footer Base

Cancer Talk Blog

Ask A Question