PATIENT INFO

Notice of Privacy Practices

Bill of Patient Rights

Release of Patient Information

Medicare Advantage Collecting New Patient Demographic Info. Request to Amend Protected Health Info.

IMPORTANT INFO for RELEASE OF INFORMATION

  • Photo ID must be attached to the form (patient and person picking up the records)
  • Form must be completed entirely and signed (physical signature, e-sign not accepted.)
  • HIM staff has 15 business days to complete a request
  • HIM business hours are Monday-Friday 8 am – 4 pm