Forms & Policies

Coming to the hospital or clinic? Find current patient & visitor policies.

Patient Rights & Policies

HIPAA: Your Privacy

We keep your medical records and health information private, complying with HIPAA. View:

Medical Records Release Forms

Allow the sharing of your medical records and/or health information with a third party: 

Request limits on who receives some or all of your health information:

Prevent disclosure to your health insurance of a healthcare service that you have paid for in full:

Allow a provider to share your medical information with another patient:

Find out when and to whom your health information was shared:

Ask for changes or corrections in your medical record: 

MyChart Forms: Access Requests

Request access for another adult to your MyChart account: 

Request caregiver access to an incapacitated adult's MyChart account: 

Request access to a patient's medical records for non-clinical purposes:

Access to a Child's MyChart

Request access to a child's (under age 13) MyChart account:

Request access to an adolescent child's (over age 13) MyChart account:

Give the Hospital Education Program access to your child's medical records: 

Advance Directives

Use an advance directive to plan your future medical care and health decisions.

Choose your advance directive form options.

Clinic Late, No-Show, & Cancellation Policy

  • If you’re late to your clinic appointment, and we can’t fit you in, we’ll reschedule your appointment.
  • New patient? After 2 no-shows for a first appointment, we won’t reschedule you.
  • Already a patient? If you have 3 no-shows in 1 year, we may dismiss you from the clinic.
  • We treat 2 late cancellations the same as 1 no-show. 
  • We know things happen. We don't count no-shows and late cancellations that happen for reasons outside your control. 

Definitions

  • No-show: Not coming to an appointment and not calling ahead to let us know you can't make it. 
  • Late cancellation: Cancelling with less than 24 hours’ notice. 

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