U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Freedom Of Information Act (FOIA)

Sample FOIA Request

[IHS FOIA Staff] or [IHS FOIA Officer]
IHS/Division of Regulatory Affairs
801 Thompson Ave (TMP 450)
Rockville, MD 20852

To: IHS FOIA Staff/or Designate Area FOIA Office:

Under the Freedom of Information Act (FOIA), I would like to request a copy of [insert the name of the document or information that you are seeking and please be specific. If you would like documents for a specific time period, please state the time frame in the request also.]

NOTE: If you are not sure whether or not the information can be found at the Area level or at the HQ level, you may send your request directly to the FOIA Staff in Rockville, MD; and we can forward your request to the appropriate Area FOIA Coordinators. We can coordinate the document retrieval from that Area office.

Thank you!

Your Name
Your Address
Your City, Your State
Your Zip Code
Your Phone Number (FOIA Staff only calls a requester with general questions or when we need to request that the scope is narrowed).

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