Health Services Privacy Notice

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

We respect every patient's right to privacy. We will not release personally identifiable information about you without your permission, unless, as described below, the release is in accordance with federal and state laws.

All staff members at Brown University Health Services are required to safeguard your privacy in all settings. We have procedural and physical safeguards in place to protect your information. As a user of Health Services, you give us your consent to use the information internally to provide the best care for you and to disclose information outside of Brown University Health Services, in accordance with state and federal laws as follows:

• to you, upon your request
• to a provider, such as doctors, hospitals, and others who provide medical care and services to you
• to a government or regulatory body, such as a law enforcement agency (for example, to investigate crimes), or a court (for example, in response to a subpoena), or to a public health facility (for example, to report an infectious disease such as tuberculosis)
• to an insurance company or another vendor (for example, the insurance company or companies that are responsible for paying your claims)

Although your health record is the physical property of Brown University Health Services, the information belongs to you.

You have the right to:

• request a restriction on certain uses and disclosure of your information
• obtain a copy of this notice of confidentiality practices on request.
• inspect and obtain a copy of your health record as per our policy
• amend your health record as per our policy
• obtain an accounting of disclosures of your health information
• request communication of your health information by alternative means or at alternative locations
• revoke your authorization to use or disclose health information except to the extent that action has already been taken

• maintain the privacy of your health information
• provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
• abide by the terms of this notice
• notify you if we are unable to agree to a requested restriction
• accommodate reasonable requests you may have to communicate health information by alternative means or alternative locations

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will post a revised notice on Health Services web site.
We will not use or disclose your health information without your authorization, except as described in this notice.

For more information or to report a problem:

If you have questions and would like additional information, contact Health Services Privacy Officer at (401) 863-1332.

If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer or the Secretary of the Department of Health and Human Services.

revised March 2004