Private Health Information

HIPAA Consent

We understand that your health information is personal and are committed to protecting it. We create a record of the care you receive to assure quality, for billing and to comply with legal requirements outlined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

If you choose to give access to your medical records to a spouse, significant other, or other family member, you will need to sign a HIPAA Release Form in the office. This form must be signed in person and renewed annually.

Our Privacy Policy applies to all records of your care that we maintain, whether created by facility staff or your personal doctor. Your personal doctor may have different policies regarding the doctor’s use and disclosure of your health information created in the doctor’s office. We are required by law to:

  • Keep health information about you private;
  • Give you this Notice of our legal duties and privacy practices with respect to health information about you; and
  • Follow the terms of the Notice of Privacy Practices that is currently in effect.

Read the full Privacy Policy of Memorial Health System.