Cameron University - HIPAA

HIPAA Privacy Information

The university’s Health Plans are required by law to protect the privacy of your health information as described by the federal Health Insurance Portability and Accountability Act (HIPAA), give you a Notice of the Plans' legal duties and privacy practices, and follow the current Notice (below). All employees and volunteers of the university’s Health Plans will follow these regulations.

Health Plan Forms

Accounting Disclosures Log Accounting Disclosures Log
Accounting of Disclosures Accounting of Disclosures
Alternative Means Communication Alternative Means Communication
Amendment PHI-HSC Amendment PHI-HSC
Authorization Release Request Individuals Health Information Authorization Release Request Individuals Health Information
Authorization Verbal Release PHI Authorization Verbal Release PHI
Confidentiality Agreement Volunteers Visitors Confidentiality Agreement Volunteers Visitors
Denial Individuals Request PHI Denial Individuals Request PHI
Electronic Medical Record Usage Agreement for External Auditors Electronic Medical Record Usage Agreement for External Auditors
Electronic Notice Of Privacy Practice Electronic Notice Of Privacy Practice
Fax Cover Sheet Fax Cover Sheet
HIPAA Privacy Complaint Report HIPAA Privacy Complaint Report
Non Clinic Employee Role Non Clinic Employee Role
PHI Amendment Notification Form PHI Amendment Notification Form
Release To Law Enforcement Release To Law Enforcement
Request for Restrictions Use Disclosures PHI Request for Restrictions Use Disclosures PHI
Revocation of Request for Restrictions on Use and Disclosure of PHI Revocation of Request for Restrictions on Use and Disclosure of PHI

Privacy Practices

Notice Privacy Practices Employee Health Plan Notice Privacy Practices Employee Health Plan

Contact Human Resources

Kynzie Pierce
kpierce@cameron.edu
(580) 581-2224