The following form is utilized by TennCare for processing a public records request. A requestor may use a copy of the form produced below or the electronic version of the form available on the TennCare website at https://www.tn.gov/tenncare/
Tenn. Comp. R. & Regs. 1200-13-11-.09
Authority: T.C.A. §§ 4-5-202, 10-7-503, and 71-5-105.