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Patient Services
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Patient Forms & Privacy

HIPAA: Your Privacy

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

Read and sign our HIPAA notice of privacy practices (PDF) 

Advance Directives

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

Read about the planning process and your advance directive form options.

Sports and School Entry Forms

Fill out and bring these forms to your primary care provider when needed:

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 MyChart account:

Para solicitar acceso a la cuenta de MyChart de su niño: 

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

Medication List

Keep track of the medicines you take with this medication card (PDF).
Make an Appointment

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or make an appointment online.