AIM Open Records Request Form

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Please enter the date you are submitting this request. *

YYYY

What is your full name (first and last)?

What is your mailing address? *

What is your phone number? *

What is your email address? *

Please provide a description of the records being requested. *

Please be as detailed as possible and include if you want to inspect/review or obtain copies).

By submitting this request, I acknowledge and understand that The Academy for Innovation in Medicine (AIM) has three (3) business days to response to this request pursuant to O.C.G.A. § 50-18-72 (the Georgia Open Records Act). *

Yes, I acknowledge and understand that The Academy for Innovation in Medicine (AIM) has three (3) business days to response to this request pursuant to O.C.G.A. §50-18-72 (the Georgia Open Records Act).

AIM is authorized to impose upon you a reasonable charge for the research, retrieval, redaction, and other administrative costs of complying with your inquiry, including copying charges of $.10 per standard page and a charge of $16.12 per hour for the time you spend reviewing documents to begin after the first quarter hour (15 minutes). *

I understand and accept these potential costs.

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