Right to Inspect and Copy

You have the right to request to inspect and copy medical information that may be used to make decisions about your care. There may be exceptions to this such as access to psychotherapy notes, information compiled in anticipation of or for use in civil, criminal or administrative proceedings or information that may be governed by other regulations such as the Clinical Laboratory Improvement Act. To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Medical Records Department of the facility. There may be fees for the costs of copying, mailing or other supplies associated with your request.

We may deny your request to inspect and copy in certain very limited circumstances. Examples of these circumstances include if the information was obtained under a promise of confidentiality; if access to the information in question is reasonably likely to endanger the life and safety of you or anyone else; if the information makes reference to another person and your access would likely cause harm to that person or if you are an inmate of a correctional facility. If you are denied access to medical information, you may request that the denial be reviewed.

Right to Amend

If you feel that medical information we have about you is incorrect, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the hospital. To request an amendment, your request must be made in writing and submitted to the Medical Records Department of the facility. We may deny your request for an amendment if it is not in writing. In addition, we may deny your request if you ask us to amend information that was not created by us; is not part of the medical information kept by or for the hospital; is not part of the information which you would be permitted to inspect and copy; or is accurate and complete.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

Printable Copy

Right to an Accounting of Disclosures

You have the right to request an accounting of disclosures. This is a list of the disclosures we made of medical information about you. This accounting will not include disclosures made for: purposes of treatment, payment or health care operations; made to you or authorized by you; from our facility directory; to persons involved in your care; for national security purposes; relating to inmates; incidental purposes; or related to a limited data set. To request this list or accounting of disclosures, you must submit your request in writing to the Medical Records Department of the facility. Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions/ Confidential Communications

 You have the right to request a restriction on the medical information we use or disclose about you for treatment, payment or health care operations. For example, you may request that your information not be included in our facility directory. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work instead of at home. Your request must be in writing. It may be submitted at the time of registration or during your hospital stay. We are not required to fulfill all requests for restrictions or confidential communications. We will review your request and attempt to accommodate all reasonable requests.