HIPAA Notice and Privacy Forms
HIPAA Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please note: this notice is intended for our fully insured/premium members. Those members of a self-funded plan should obtain a plan from your employer/group health plan.
Notice of Privacy Practices
Privacy Forms
Standard Authorization Form
Standard Authorization Form
Instructions for Completing the Standard Authorization Form
Access Request
Disclosure Accounting Request
Amendment Request
Response to Denied Amendment
Confidential Communications Request
Restriction Request
HIPAA Complaint
