Legal and Compliance

Helpful Documents & Forms

Notice of Privacy Practices

Notice of Privacy Practices – Spanish

Notice of Non-Discrimination

Notice of Non-Discrimination – Spanish

Good Faith Estimate Disclosure

Good Faith Estimate Disclosure – Spanish

Platform Privacy Statement

Surprise Medical Bills Flyer

Surprise Medical Bills Flyer – Spanish

Patient Bill of Rights

Alternative Communication Form

Authorization for Use and Disclosure of PHI Form

HIPAA Revocation of Authorization Form

Request to Restrict Use & Disclosure of Health Information Form

Patient Request for Restriction to Healthcare Insurance Form

Medical Record Release of Health Information Authorization Form

Accounting of Disclosures Request Form

Revocation of Alternative Communication Form

HIPAA Restriction Revocation Form

Additional Resources

How to File a HIPAA Privacy/Security Complaint

Understanding Health Information Privacy

How to File a Complaint with the Office of Civil Rights