Privacy & information rights
Privacy Rights Request
Use this form to ask Empowered Services LLC to help you exercise a privacy right. We will acknowledge your request and contact you to verify identity before releasing, correcting, or deleting information.
Please do not enter medical information, diagnoses, Medicaid numbers, Social Security numbers, case details, or other sensitive records in this form. We only need enough information to contact you. If additional information is required, our Privacy Officer will provide a secure method.