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Public Records Request Form

Use the North Central Behavioral Health Board's Public Records Request Form to request public records. The form is available as both an accessible web page and a downloadable PDF.

Public Records Request Form Application

Any person can make a request for public records by asking a public office or person responsible for public records for specific, existing records. The requester may make a request in any manner the requester chooses: by phone: 419-448-0640; by email: director@ncbhb.org; in person or letter. The requester must identify the records being sought “with reasonable clarity,” so that our office can identify responsive records based on the manner in which it ordinarily maintains and accesses the public records it keeps.

Fields marked with * are required.

Request for Public Record Form
Address (required for mail)
Address (required for mail)
City
State/Province
Zip/Postal
Records format preferred
Records received method: