New Federal Regulations Re: Patient Privacy
(Download forms below.)
New Federal regulations, the Health Insurance Portability and Accountability Act (HIPAA), went into effect April 14, 2003. These regulations affect how we may use and disclose your child's Protected Health Information (PHI) contained in our Clinic's medical records.
Under this new law, we are required to provide you with a Notice of Privacy Practices that describes how health information that we maintain in our Clinic will be used or disclosed. This notice explains your rights and our obligations under Federal and State privacy laws. We will ask you to sign a form acknowledging that you have received and read a copy of the Notice of Privacy Practices.
We are permitted to use and disclose your child's health information in a limited number of ways. Sometimes we must obtain your authorization before we use or disclose that information, but in other circumstances we may disclose information without specifically informing you of each use and disclosure and without requesting specific authorization. Some of the reasons that we may use or disclose the information include:
Although the original copy of your child's medical record that we maintain in the Clinic belongs to us, under the Federal law you have specific rights regarding the information within the records. You have the right to access the medical record and to have copies provided to you. You have the right to request us to amend information in the medical record that you believe is incorrect or incomplete. You may also request a list of the disclosures of your child's personal health information that we have made. Some of these rights are subject to some exceptions that we have detailed in the full Notice.
Under certain circumstances, Washington State law allows minors under the age of eighteen to give consent for medical care without the permission of a parent or guardian. Patients over the age of eighteen will be given a Notice of Privacy Practices and will be asked to sign an acknowledgment that they have received it. They will also be given the option to sign a consent form for the disclosure of their Protected Health Information to their parent or guardian. The full Notice contains further details about the rights of minor children.
We have provided
Notice for download (below),
so that you will have the opportunity to read and print this Notice before
coming in for your child's next appointment. Please read it carefully, and
sign the acknowledgement, which will be filed in your child's medical record.
If you have any questions or if you require additional information, please
contact our office manager, Janine Peterson at firstname.lastname@example.org. You may also call
Janine directly at 206-783-3524.
|Read the full Notice:|
|Download the acknowledgement form:||Download as PDF
Download as Word document
(If you have trouble opening the PDF files, download the free Adobe Acrobat Reader.)