91Â鶹

Confidentiality Statement

Protecting personal records is of utmost importance. 91Â鶹 prohibits unauthorized access or disclosure.

Disclosure Declaration-Breach Mitigation

If you receive health information or other confidential information you did not request, please complete this form.

Privacy Incident Intake Report

Report a privacy incident to Compliance, Ethics & Risk Management.

Fax Transmittal Cover

Please use this cover sheet when faxing confidential health care information.

Law Enforcement Request for PHI

When receiving a request for information from law enforcement, please complete this form and adhere to its guidelines.

Report Lost or Stolen Device

If you're not able to locate a device containing sensitive data, please complete this form as soon as possible.

Research HIPAA Authorization Checklist

Request for Review of HIPAA Authorization Language for Research