BCMHD: Data, Information & Letter of Support Request Form

Data/Information released from the Broome County Mental Health Department (BCMHD)/Local Government Unit (LGU) is considered the intellectual property of the LGU. Prior to release, all data/information will be reviewed to ensure data integrity and completeness. Approved release of data/Information is for the purpose of this request only and may not be re-released or used outside of the scope of this request without additional authorization. Data/Information may not be segmented or misrepresented. The LGU reserves the right to deny any request or amend the scope of information released to ensure protection of county constituents. All requests will be processed in a timely manner and unless emergent, will be processed in the order they are received.

 
 
 
 
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Please be as specific as possible

 
 

Please describe the reason this information is needed, who will have access to it and intended use.

 

By checking this box, the requester agrees to the terms of use and that the above information is true to the best of their knowledge.

 

Thank you!