AGENCY: Department of Health and Human Services. Community Health and Well-Being. Division of Family Health. Office of Early Childhood

SERIES: 31260
TITLE: Contact Me request forms
DATES: 2025-
ARRANGEMENT: Chronological by date of request.

DESCRIPTION: These records are used to collect care coordination requests made by website users.

See Utah Code 26B-1-202(2)(dd); Individuals with Disabilities Education Act, Part C (US Code); and Title 34 of the Code of Federal Regulations, Part 303.

Information includes client name (whatever information the website user provides, first and last are not required), telephone number, email address, preferred contact method, and open text comment.

Privacy annotation:

Purpose personal identifying information (PII) is collected, maintained, or used:

Personal information is collected so that care coordinators can respond to the request for service. Users do not have to input their information in order to utilize the website, the contact information is only used when the user is requesting follow-up via a care coordinator.

List of PII:

These records may contain full name, email, telephone number and county of residence.

RETENTION

Retain for 3 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series is authorized by Archives general schedule Customer request or complaint records, GRS-1783

AUTHORIZED: 07/10/2025

FORMAT MANAGEMENT

Computer data files: Retain in Office for 3 years and then delete.

APPRAISAL

Administrative

PRIMARY DESIGNATION

Exempt. Utah Code 26B-8-4

SECONDARY DESIGNATION

Exempt. Individuals with Disabilities Education Act, Part C (US Code); Title 34 of the Code of Federal Regulations, Part 303

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