EvergreenHealth Monroe

360.794.1405 (Call 24/7)

The Recovery Center, a service of EvergreenHealth Monroe, is committed to protecting your privacy and the privacy of your medical information.The Health Insurance Portability and Accountability Act (HIPAA) gives The Recovery Center and EvergreenHealth the right to use and disclose your medical information for treatment, payment and certain health care operations purposes without specific authorization from you. Our notice of privacy practices describes how we may use and disclose the medical information that we maintain. We encourage you to read our full Notice.You will be offered a copy of our Notice of Privacy Practices the first time you register or present for treatment or health care services at The Recovery Center. You may also request a copy of the Notice at any time or download a copy here:

You also have these specific rights regarding your medical information:

Right to request access to or a copy of your medical information. We will ask that you make your request specific and in writing. We may charge a reasonable fee for the cost of producing and mailing the copies. In certain situations, we may deny your request and will tell you why we are denying it. In some cases, you may have the right to ask for a review of our denial.

Download Authorization to Disclose Healthcare Information form (PDF)

Right to request an amendment to your medical information if you believe our records are incomplete or inaccurate. Your request for amendment must be in writing and provide the reason for your request. In certain cases, we may deny your request. If so, we will notify you in writing. You may respond by filing a written statement of disagreement with us and ask that the statement be included with your medical information.

Download Request for Amendment of Patient Record form (PDF)

Right to request restrictions by asking that we limit the way we use or disclose your medical information for treatment, payment, or health care operations. You may also ask that we limit the information that we give to someone who is involved in your care, such as a family member or friend. We are not required to agree to your request. If we do agree, we will honor your restriction unless it is an emergency. We may ask you to make your request in writing.

Download Restrict Disclosure of Protected Health Information form (PDF)

Right to identify individuals other than your health care providers who are involved in your care (family, friends, or others). We may verbally share your medical information to an individual you have identified as involved in your medical care. We may also give information to someone who helps pay for your care. EvergreenHealth will only share your health information with the individuals you designate, except as required or permitted by law. You may add or change this list at any time.

Download Individuals Involved In Care form (PDF)

Right to request that we communicate with you by another means to preserve confidentiality. For example, if you want us to communicate with you at a different address or telephone number we can usually accommodate your request if it is reasonable.

Download Request for Confidential Communication form (PDF)

Right to seek an accounting of certain disclosures by asking us in writing for a list of the disclosures we have made of your medical information, except for disclosures for treatment, payment, health care operations, information provided to you, facility directory listings, certain government functions, and disclosures made prior to April 14, 2003.

Download Request Accounting of Disclosures form (PDF)

Questions about our Privacy Policy?

If you have questions relating to the protection of your medical information or EvergreenHealth's privacy practices, please contact :

Richard Meeks
EvergreenHealth Privacy Officer

Phone: 425.899.2011
Email: RAMeeks@evergreenhealth.com


17880 147th St SE, Monroe, WA 98272

Privacy Policies

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