Open Records Request Form

First Name

Last Name

Organization

Address

City

State

Zip Code

Phone Number

Fax Number

E-mail Address

Oklahoma Health Care Authority – Open Records Act – Fee Schedule

Under 51 Okla. Stat. § 24A.5(3), the Oklahoma Health Care Authority is required to post a schedule of its fees with the county clerk and in its principal place of business.

Fee Schedule for Cost of Reasonable Direct Cost of Record Copying

.10 PER PAGE

Fee Schedule for Cost of Record Search and Reasonable Direct Cost of Record Copying

(A) .10 per page for reproduction, PLUS

(B) Fee per hour for state employee searching for records/depending on salary, PLUS

(D) Actual state cost of electronic storage device to send production request (such as CD, thumb drive, disc, etc.)

IF ANY EQUALS TOTAL FEE

Description of Document(s) Requested

Once OHCA receives your payment, we will supply you the documents in one of the manners listed below.

How Do You Want Your Documents?

Mail the documents to the above address

I will pick up the documents

Electronic submission (Depending on size of zipped file, we either email it to you or we provide a special download link)

Additional Notes

Upload Supporting Document (20mb max)
Select a supporting file that you want to submit with this request.
Click the "Upload" button after selecting the file.
Only files of the following types will be allowed:

Microsoft Word - .doc and .docx
Microsoft Excel - .xls and .xlsx
Adobe PDF - .pdf
Image Formats - .bmp, .jpg, .jpeg, .png, .tif, and .tiff

Selected File: - None -

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