3899 (8)


Resources regarding CCATT mission documentation may be found here. Select one of the subcategories above for specific files


  • Send all 3899L's via email or fax to:
  • Subject line to include:  ATTN:  CCATT PI Program
  • Include Privacy Policy:  

NOTICE:  This document may contain information covered under the Privacy Act, 5 USC 552(a),and/or the Health Insurance Portability and Accountability Act (PL 104-191) and its various implementing regulations and must be protected in accordance with those provisions. Health care information is personal and sensitive and must be treated accordingly. If this correspondence contains health care information it is being provided to you after appropriate authorization from the patient or under circumstances that don't require patient authorization. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Re-disclosure without additional patient consent or as permitted by law is prohibited. Unauthorized re-disclosure or failure to maintain confidentiality subjects you to application of appropriate sanction. If you have received this correspondence in error, please notify the sender at once and destroy any copies you have made.

The policy letter outlining the use of and submission of may be found here .

Detailed instructions on filling it out correctly may be found here.

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