Patient Privacy/HIPAA Rights

Catholic Health and its affiliated covered entities (collectively, Catholic Health) is committed to ensuring that your medical information is private and secure. Catholic Health protects medical information as required by state laws and the federal privacy rules of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to ensure the security and privacy of your medical records and promote trust between our patients and their health care providers.

Notice of Privacy Practices

Catholic Health maintains a Notice of Privacy Practices that describes the ways in which our covered entities may use and disclose your health information and how you can obtain access to this information. Every patient will be provided with a copy of the Notice when they first come to a Catholic Health provider for treatment and will be asked to sign an acknowledgment that they received a copy of our Notice. Please download the following documents for detailed information on our privacy practices.

Catholic Health Notice of Privacy Practices - English

Catholic Health Notice of Privacy Practices - Spanish

Patient Forms

Inspecting and Obtaining Copies of Your Medical Records

You are entitled to request that a copy of your medical record be released to you or a designated person by downloading and completing the following request form. All forms requesting medical records must be submitted by mail or in person to the Health Information Management (HIM) Department of the specific Catholic Health facility or practice that treated you.

For copies of your billing information, please submit your request in writing to the Director of Patient Accounts at Catholic Health.

Authorization for Release of Health Information Pursuant to HIPAA

Requesting an Amendment to Your Medical Record

You are entitled to request an amendment be made to your medical record by downloading and completing the following request form. This form must be submitted by mail or in person to the Health Information Management (HIM) Department of the specific Catholic Health facility or practice that treated you.

Patient Request for Amendment of Records

*Please note that these forms should NOT be sent to Catholic Health*

The information you are requesting may be available free of charge through Catholic Health MyChart, our secure patient portal. With a Catholic Health MyChart account you can view: test results, immunizations, medication lists, visit and admission summaries, and appointment information from your home computer or compatible smart phone/tablet. Please note: The portal only provides access to portions of the electronic medical record–it is not an all-inclusive medical record. Please ask your doctor about signing up for Catholic Health MyChart.