Confidentiality & Request for Records

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HIPAA:
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Understanding Your Health Information:
Each time you visit a clinician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment and plan for future care or treatment. Being aware of what is in your health record will help you to make more informed decisions when authorizing disclosure to others.

Your Health Information Rights
Although your health record is the physical property of Union University Student Health Services, the health information it contains belongs to you. You have the right to:

• Inspect and obtain a copy of your health information; there are a few exceptions and copy charges may apply.
• Request to amend your health information.
• Revoke your authorization to use or disclose health information expect to the extent that action has already been taken prior to revocation.
• Request a restriction on certain otherwise permitted uses and disclosures of your information; however, we are not required to agree in all circumstances.
• Request a written accounting of disclosures of your health information for the previous six years but not before April 14, 2003 for disclosures other than those made to you, for treatment, payment, or healthcare operations or other limited exceptions.
• Request communications of your health information by alternative means or at alternative locations and to obtain a paper copy of this notice upon request.

If you wish to exercise any of these rights, please contact the Student Health Services Director at 731-661-5284.

Request for Health Records
Students, Faculty and Staff requesting a copy of their health records Will need to complete the Release of Information Form and submit this to the Health Clinic. This procedure may be completed on line by downloading the release form and faxing it to the Health Clinic (731-661-5499) or by personal pick-up during regularly scheduled clinic hours.