These forms allow you to exercise your privacy rights by printing, completing, and mailing these forms to USAble Life, Privacy Office, P.O. Box 1650, Little Rock, AR 72203-1650.

Request to Inspect Health Information 

Request for Restrictions 

Request for Confidential Communications 

Request to Correct or Amend Record 

Request for Accounting 

Appointment of Authorized Representative 

Authorization for Release of Medical Records