Personal Information Removal Request Form

(Disclaimer: Some personal information collected by CDCR/CCHCS that is connected to you and categorized as a public record may not be removed, such as a professional license number. Other personal information may not be removed as retention may be required by law, such as employee records, certain billing and/or financial information for state contracts, or other activities for audit and/or other actions, administrative, or legal proceedings).

Contact Us