Effective Date: January 1, 2008
JOINT NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE
USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION. PLEASE REVIEW IT CAREFULLY.
Providence Health & Services is committed to protecting the confidentiality of your health
This Privacy Notice covers an Organized Health Care Arrangement ("OHCA"), made
up of the entities listed on the last page of this Notice.
We are required by law to maintain the privacy of your medical information. We are also
required to notify you of our legal duties and privacy practices regarding your medical
information, and abide by the practices of this Notice, unless more stringent laws or
regulations apply. This Notice applies to all Providence Health & Services facilities, services,
and programs that provide health care to you. You may request an up-to-date list of those
facilities, programs, and services, by contacting us at (800) 628-PROV (800-628-7768).
Who This Notice Applies To
This Notice describes this facility/organization’s practices and those of:
• Any health care professional authorized to enter information into your facility record
• Any member of the medical staff credentialed to practice at this facility;
• All departments and units of this facility
• All employees, staff, and other facility personnel
• Any volunteer, intern, or student we allow to help you while you are a patient at this
This Notice of Privacy Practices provides detailed information about how we may use and
disclose your medical information with or without authorization as well as more
information about your specific rights with respect to your medical information. This
Notice becomes effective April 14, 2003.
Disclosures Of Your Medical Information That We May Make Without
Authorization for Treatment, Payment, and Operations
Treatment: Your information may be shared with any provider who is providing you with