Effective May 1, 2012
This notice describes how medical information about you may be used and disclosed and how you can access this information.
This Notice Of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). It describes the limits to which we may use or disclose your protected health information, with whom that information may be shared, and the safeguards we have in place to protect it. This notice also describes your rights to access and amend your protected health information. You have the right to approve or refuse the release of specific information outside of our system, unless the release is required or authorized by law or regulation.
For further clarification of our Notice of Privacy Practices, email us at firstname.lastname@example.org or call (206) 543-3098. You may also write to:
UW Medicine Compliance
Seattle, WA 98195-8049
Additional Resources U.S. Department of Health and Human Services 200 Independence Ave SW Washington, DC 20201 www.hhs.gov Acknowledgment of Receipt of This Notice Each patient is asked to sign a consent form referencing this notice. Our intent is to make you aware of the possible uses and disclosures of your protected health information and your privacy rights. However, the delivery of your healthcare services will in no way be contingent upon your signed acknowledgment. We will provide you appropriate care whether or not you sign the form. Who Will Follow This Notice This notice describes Valley Medical Center (VMC) practices regarding your protected health information. As authorized in its Medical Staff Policies, Valley Medical Center has an organized healthcare arrangement, which includes all active medical staff as participants in this Notice of Privacy Practices.