Contacts

 

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule, which became effective April 14, 2003, provides for limits on the use and disclosure of any information about you which relates to your past, present or future physical or mental health or health care services from which you can be identified. It does so through the creation of national standards to protect individual's medical records and other personal health information. We urge you to be familiar with the information provided below.

Notice of Privacy Practices

 

HIPAA Privacy Forms

Use these HIPAA Privacy Forms to print, fill out and mail to the MCTWF Privacy Officer at the address listed on bottom of each form (note that these forms cannot be filled out and submitted electronically).  Adobe Acrobat Reader is required for viewing and printing and can be downloaded free of charge by clicking on the Acrobat Reader icon on this page.

For a description of each form listed below, please refer to the Notice of Privacy Practices.

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