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Cincinnati Children’s Hospital Medical Center (Cincinnati
Children’s) is required by law to maintain the privacy of patient protected
health information, provide patients with notice of our legal duties and
privacy practices regarding protected health information, and notify
individuals when a breach of unsecured protected health information occurs. We understand that your health information is
highly personal. We are committed to
safeguarding your privacy.
Please read this Notice thoroughly. It describes how we may use and disclose your
protected health information for treatment, payment, and health care operations
purposes, and for other purposes that the law allows. It also describes your
legal right to access and control the use and disclosure of your protected
The rights outlined below belong to the patient or the patient’s personal
representative, which is the patient’s parent, legal guardian or any person
that has the legal authority to
represent the interests of the patient and act on the patient’s behalf. If there is any question as to whether a
person is legally qualified to act as a patient’s personal representative, please
contact the Privacy Officer at the phone number or address listed at the end of
We are permitted to use or disclose to others outside Cincinnati Children’s your health information without permission from you for three basic types of activities:
Healthcare Operations − We
are permitted to use your health information or disclose it to others outside Cincinnati
Children’s in order to run the hospital and ensure high quality care. For example, we may use or disclose your
information to review how we provide care to you, help us improve how we
operate the hospital, meet compliance or licensing requirements, or send you
We are required to protect the privacy
of your information, establish Policies and Procedures that do so, provide this
Notice about our privacy practices, and to follow the practices described in
We reserve the right to change our
Policies and Procedures for protecting health information. When we make a
significant change in how we use or disclose your health information, we will
also change this Notice and post the new Notice in waiting rooms and registration
areas. You can request a written copy of the most recent version of this Notice
at any time. It is also posted on our
website at www.cincinnatichildrens.org.
you believe we have not properly protected your privacy, have violated your
privacy rights, or you disagree with a decision we made about access to your
protected health information, you may contact our Privacy Officer at the
address listed below.
You also may send a written complaint to the US Department of Health and Human
Cincinnati Children’s Privacy Officer can provide you with the appropriate
address upon request. There will not be
retaliation against those who choose to file a complaint.
To act on any of the information provided in this Notice
or for more information about our privacy practices, you may contact our Privacy Officer.
Phone: 1-800-344-2462 or 513-636-4707
Fax: 513-636-4076Email: firstname.lastname@example.org
Mail:Cincinnati Children's Privacy OfficerRisk Management / Corporate Compliance, MLC 9010 Cincinnati Children’s Hospital Medical Center 3333 Burnet Ave. Cincinnati, OH 45229-3039
This Notice was issued on August 15, 2013.
3333 Burnet Avenue, Cincinnati, Ohio 45229-3026 | 1-513-636-4200 | 1-800-344-2462 | TTY: 1-513-636-4900
New to Cincinnati Children’s or live outside of the Tristate area? 1-877-881-8479
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