At Women’s Health Center of Southern Oregon, protecting your privacy and confidentiality and informing you of your rights and responsibilities is very important to us. If after reviewing the below notices you have any questions, please do not hesitate to let us know.
Our Notice of Privacy Practices
This notice covers our privacy practices. When you establish as a new patient at Women’s Health Center, we will ask you to sign an acknowledgment of this notice; please review these policies and ask any questions prior to signing.
Authorization to Verbally Discuss My Healthcare with Others
Please print and complete this form if you wish to allow our office to discuss your healthcare with anyone besides you. For instance, if you have a caregiver or a family member who assists you in scheduling appointments, making healthcare decisions or other aspects of your care, it is necessary for you to complete and sign this form to allow Women’s Health Center to communicate with that individual about you.
Authorization to Disclose Private Health Information
Please print and complete this form if you wish us to send your medical records to another healthcare provider or entity.
Patient Rights and Responsibilities
This document informs you of your rights as a patient of Women’s Health Center as well as the responsibilities you have to us.
Notice Informing Individuals About Nondiscrimination and Accessibility
This document informs you of Women’s Health Center’s compliance with applicable Federal civil rights laws.