Other Uses and Disclosures Require Your Written Authorization
• For All Other Situations.
We will ask for your written authorization
before using or disclosing PHI about you. You may cancel this authorization at any
time in writing, or by other appropriate means of communication if necessary. We
cannot take back any uses or disclosures already made with your authorization.
• Other Laws Protect PHI.
Many of our programs have other laws
for the use and disclosure of PHI about you. For example, you must give your written
authorization to us before we can use and disclose chemical dependency treatment
records. Your PHI Privacy Rights
• Right to See and Get Copies of Your PHI.
In most cases, you have
the right to look at or get copies of your PHI. You must make the request in writing.
You may be charged a fee for the cost of copying and mailing the PHI to you.
• Right to Request to Correct or Update Your PHI.
You may ask us
to change or add missing PHI if you think there is a mistake. You must make the
request in writing and provide a reason for your request. However, there are conditions
under which we may deny this request.
• Right to Get a List of Disclosures.
You have the right to ask
us for a list of disclosures made after April 14, 2003 and up to six years prior
to the date you made the request. You must make the request in writing. This list
will not include the times that PHI about you was disclosed for treatment, payment,
or health care operations. This list will not include PHI about you provided directly
to you or your family, or PHI that you authorized.
• Right to Request Limits on Uses or Disclosures of Your PHI.
have the right to ask us to limit how PHI about you is used or disclosed. You must
make the request in writing and tell us what PHI you want to limit and to whom you
want the limits to apply. We are not required to agree to the restriction. You can
request restrictions be terminated in writing or verbally.
• Right to Revoke Permission.
If you are asked to sign an authorization
to use or disclose PHI about you, you can cancel that authorization at any time.
You must make the request in writing. This will not affect PHI that has already
• Right To Choose How We Communicate With You.
You have the right
to ask us to share your PHI with you in a certain way or in a certain place. For
example, you may ask us to send PHI about you to your work address instead of your
home address. You must make this request in writing. You do not have to explain
the basis for your request.
• Right to File a Complaint.
You have the right to file a complaint
if you do not agree with how we have used or disclosed PHI about you.
• Right to Get a Paper Copy of this Notice.
You have the right
to ask for a paper copy of this notice at any time.