Right to Account for Disclosures
Patients have the right to request a list of when and where their confidential information was released. A list of disclosures (releases) within the past six years (starting April 2003).
- Date of disclosure
- Name of person or entity who received information and address if known
- Brief description of reason for disclosure
- Exceptions:
- treatment, payment, health care operations
Patients also have a right to request a list of when their information is released or disclosed. The list can go back as far as six years and should include the date their information was disclosed, the name of the person or entity who received the information, the address (if it is known), and a brief description of the reason for the disclosure.
The list will not be all-inclusive because it will not include information released or disclosed for care and treatment purposes, for payment, or when used in the operation of a health care facility (for example, when used for quality assurance purposes).
If you would like to view the Patient Record of Disclosures Form, click on the following link.
Patient Record of Disclosures Form
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