Patient Communication, Forms, and Policies
HIPAA and Compliance Policies
- Patient Bill of Rights
- Notice of Privacy Practices
- Nondiscrimination Notice
- Nondiscrimination Policy for persons with disabilities and limited English proficiency
- Nondiscrimination Statement - Language Accessibility
- CHC HIPAA Substitute Notice
Patient Forms
- Records Release Forms
- Private Practice Records Release Request
For use by UMSOD patients and private practice offices to request the release of patient records. - Authorization for the Use and Disclosure of Protected Information
- Private Practice Records Release Request
- Health Record Correction Requests
- Backline Patient Instructions