Refuse access to my health and personal information

Persons to whom you may refuse access

• My spouse or close relatives, if access is requested in a grievance process
• My spouse, parents or children, if it concerns information relating to the cause of my death
• A researcher, if the intended access is for the purpose of soliciting their participation in a research project
• A researcher who is not linked to a public health and social services organization, to a public institution or to a private institution under agreement that operates a hospital centre (you can specify information or categories of research activities)

Procedure to follow

To refuse access to your information or to modify or withdraw a refusal previously submitted:

1. Download and complete the form entitled Refusal of access to health and personal information
2. Print and sign the form
3. Send us the form to the following address:
   
   Régie de l’assurance maladie du Québec
   C.P. 6600, succ. Terminus
   Québec (Québec)  G1K 7T3