Privacy Practices
EvergreenHealth is committed to protecting your privacy and the privacy of your medical information.
The Health Insurance Portability and Accountability Act (HIPAA) gives EvergreenHealth the right to use and disclose your medical information for treatment, payment and certain health care operations purposes without specific authorization from you.
Notice of Privacy Practices
Our Notice of Privacy Practices describes how we may use and disclose the medical information that we maintain. We encourage you to read our full Notice.
You will be offered a copy of our Notice of Privacy Practices the first time you register or present for treatment or health care services at EvergreenHealth. You may also request a copy of the Notice at any time.
Patient Privacy Rights
You also have these specific rights regarding your medical information:
Right to request access to your medical record. Patients have the right to request access to their own medical records. Patients are encouraged to utilize MyChart to obtain this information. If you are not able to utilize MyChart, you may request to receive copies, or to review the information, a request must be in writing and routed to Health Information Management for processing.
Patient Request for Health Information (PDF)
Right to request an amendment to your medical information if you believe our records are incomplete or inaccurate. Your request for amendment must be in writing and provide the reason for your request. In certain cases, we may deny your request. If so, we will notify you in writing. You may respond by filing a written statement of disagreement with us and ask that the statement be included with your medical information.
Download form (PDF)
Amendment Request Process Patient FAQ
Right to request restrictions by asking that we limit the way we use or disclose your medical information for treatment, payment, or health care operations. You may also ask that we limit the information that we give to someone who is involved in your care, such as a family member or friend. We are not required to agree to your request. If we do agree, we will honor your restriction unless it is an emergency. We may ask you to make your request in writing.
Download form (PDF)
EvergreenHealth participates in a Health Information Exchange (HIE) through Epic Care Everywhere that allows health organizations who utilize Epic as their electronic health record system to exchange electronic health information. This information is shared through secure, electronic means and allows providers to have the most recent available information to care for you as a patient. You may opt out if you do not want your health information to be shared with or received by your treating provider(s) through Epic Care Everywhere. If you opt out, you also have the right to opt back in at any time by completing this form.
Download form (PDF)
Right to request that we communicate with you by another means to preserve confidentiality. For example, if you want us to communicate with you at a different address or telephone number we can usually accommodate your request if it is reasonable.
Download form (PDF)
Right to seek an accounting of certain disclosures by asking us in writing for a list of the disclosures we have made of your medical information, except for disclosures for treatment, payment, health care operations, information provided to you, facility directory listings, certain government functions, and disclosures made prior to six (6) years from the date of request.
Download form (PDF)
