SCEMS HIPAA Rules

We have supplied here, all of our HIPAA Privacy forms and a copy of our Notes of Privacy Practices. You can download a copy of any of this forms by clicking on the links below. All are in Acrobat form.

Notes of Privacy Practices

Patient Request for Access Form

Request for Amendment of Protected Health Information Form

Patient Request for Restriction Form

Authorization to Use and Disclose Specific Protected Health Information Form

Procedure for Filing Complaints About Privacy Practices

List of Designated Privacy Officials

Many files on the web site are in Adobe Acrobat (PDF) format. If you don't have this program, you may click here to download a free copy of the Adobe Acrobat Reader to view these files. The file is approximately 4 Mb in size. Please note that files on this web are in Acrobat Version 4.0. If your Adobe reader is earlier than version 4.0, you will need to download the new viewer to read some files. The pages which require Adobe Acrobat are marked with a icon

Last modified: April 14, 2003