- Notice of Privacy Practices - English (PDF)
- Notice of Privacy Practices - Spanish (PDF)
- Notice of Privacy Practices - Russian (PDF)
- Notice of Privacy Practices - Farsi (PDF)
- Notice of Privacy Practices - Chinese Traditional (PDF)
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.
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.
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.
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.
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.
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.
If you have questions relating to the protection of your medical information or EvergreenHealth's privacy practices, please contact :
EvergreenHealth Privacy Officer