Stanford Health Care, the "Hospital" values and is
committed to protecting the privacy of health information we create or
receive about you. Health information that identifies you
("protected health information," or "health
information") includes your medical record and other information
relating to your care or payment for care.
Our notice of privacy practices
The Hospital will provide you with a Notice of Privacy
Practices – English version / Spanish version that explains our privacy
practices and your rights regarding your health information. The first
time you receive care on or after September 23, 2013, the Hospital
will provide you with a copy of our current Notice and ask you to
acknowledge its receipt. The Hospital may need to change its privacy
policies and practices from time to time and will update the Notice accordingly.
You may ask for a copy of our current notice at any time in any of
the patient registration areas throughout the Hospital, including
clinics, and it is publicly posted in a number of places. You can also
view and print a copy of our current Notice by clicking on Notice
of Privacy Practices – English version / Spanish version.
Throughout these pages on patient privacy you may click on items
that are in italics and underlined and an Adobe PDF file version of
a document or form will open for your review or to be printed.
Your rights regarding health information about you
An important part of the Hospital's Notice is the section that
explains your rights regarding your health information. Our Notice
explains that you (or your personal representative) have the right to:
Inspect or copy
You have the right to inspect and obtain a copy of the health
information that may be used to make decisions about your care.
Usually, this includes medical and billing records, but may not
include some mental health information. We reserve the right to charge
a fee to cover the cost of providing your health information records
For more information of how and where to inspect or obtain a copy of
your health information and print copies of the necessary forms,
please click on Medical Records.
Request an amendment or an addendum:
If you believe that health information the Hospital has on file about
you is incorrect or incomplete, you may ask us to amend the health
information. To request an amendment you must file an appropriate
written request with the Health Information Management Services (HIMS)
Department. In addition, you must provide a reason that supports your
request. The Hospital can only amend information that we created or
that was created on our behalf. If your health information is accurate
and complete, or if the information was not created by the Hospital,
we may deny your request to amend. If we deny your request, we will
share with you in writing with our reasons for doing so. Requests to
amend your health information must be in writing and we recommend, but
do not require, that you use the Hospital's Request for an Addendum or Correction
form. Your written request must describe each item that you
want changed (for example: History and Physical on 3/1/2013 and Clinic
Visit Note on 4/14/2013) and the reason you are requesting the change.
Even if we deny your request to amend, you have the right to submit
a written addendum to the Health Information Management Services
(HIMS) Department. Addendums may not exceed 250 words for each item or
statement in your record you believe is incomplete or incorrect.
Requests for an addendum must be in writing and we recommend, but do
not require, that you use the Hospital's Request for an Addendum or Correction form.
Please send your request to Health Information Management Services - 450 Broadway, Mail Code 5200, Redwood City, CA 94063 or fax it to 650-725-9821. Copies of the request forms and assistance are also available at the Hospital's HIMS Department. The HIMS Department will acknowledge your request when it is received and process your request within sixty (60) days of receipt. In certain situations the HIMS Department may require an additional thirty (30) day extension to process your request.
An accounting of hospital disclosures:
You have the right to request an "accounting of
disclosures" which is a list describing how we have shared your
health information with outside parties. This accounting is a list of
the disclosures we made of your health information for purposes other
than treatment, payment, health care operations, and certain other
purposes consistent with law. You may request an accounting of
disclosures for up to six years before the date of your request. If
you request an accounting more than once during a twelve month period,
we will charge you a reasonable fee.
To request an accounting of disclosures, please print and complete the Request for Accounting of Disclosures Form. You may either mail the form to the HIMS Department at 450 Broadway, Mail Code 5200, Redwood City, CA 94063 or fax it to 650-725-9821. Copies of the Request Form and assistance are also available at the Hospital's Release of Information Office at 450 Broadway, Room C14, Redwood City, CA 94063.
You have the right to request restrictions on certain uses or
disclosures of your health information. For example, you may request
that your name not appear in the Hospital's Patient Directory while
you are here as an inpatient. Requests for restrictions must be in
writing. In most cases, we are not required to agree to your requested
restriction. However, if we do agree, we will comply with your request
unless the information is needed to provide you emergency treatment or
comply with the law. If we do not accept your request, we will reply
to you in writing with the reason.
We are legally required to accept certain requests not to disclose
health information to your health plan for payment or health care
operations purposes as long as you have paid out-of-pocket and in full
in advance of the particular service included in your request. If the
service or item is part of a set of related services, and you wish to
restrict disclosures for the set of services, then you must pay in
full for the related services. It is important to make the request and
pay before receiving the care so that we can work to fully accommodate
your request. We will comply with your request unless otherwise
required by law.
Examples of restriction requests that the Hospital cannot honor include:
Requests to restrict medical students or residents from
accessing your health information.
Requests restricting the
Hospital from giving your name to an insurance company that will be
asked to pay a portion of your bill.
the Hospital from reporting your identity and condition to an agency
or organization where the Hospital is required by law to do so.
Restrictions may be requested at any time. To make a restrictions request, please print and complete a Request for Restrictions Form. You may either mail the form to the SHC Privacy Office, 300 Pasteur Drive - MC 5780, Stanford, CA 94395-5202 or fax it to . Copies of the Request Form and assistance are also available at the Hospital's Release of Information Office at 450 Broadway, Room C14, Redwood City, CA 94063. Alternatively, you may request restrictions during the registration process at the Hospital.
To terminate a restriction that the Hospital has accepted, send your request in writing to SHC Privacy Office, 300 Pasteur Drive - MC 5780, Stanford, CA 94395-5202 or fax it to . Please include a copy of your original restrictions request or the date, patient name and medical record number that appeared on the accepted request.
The Hospital may terminate a restriction that it had previously
accepted, but must inform you in writing of the termination. In this
situation, the termination only applies to your personal health
information created or received after you have been notified of the termination.
Request confidential communications:
You have the right to request that we communicate with you about your
health information or medical matters in a certain way or at a certain
location. For example, you can ask that we only contact you at work,
rather than at your home. We will not ask you the reason for your
request. We will work to accommodate all reasonable requests. Your
request must be in writing and specify how and where you wish to be contacted.
To make a confidential communications request, please print and complete a Request for Confidential Communications Form. You may either mail the form to the SHC Privacy Office, 300 Pasteur Drive - MC 5780, Stanford, CA 94395-5202 or fax it to . Copies of the Request Form and assistance are also available at the Hospital's Release of Information Office at 450 Broadway, Room C14, Redwood City, CA 94063. Alternatively, you may request confidential communications during the registration process at the Hospital.
Receive a copy of the hospital's notice of privacy practices:
You have the right to a copy of the Hospital’s current Notice of
Privacy Practices. It is available in registration areas and by
clicking the link "Patient Privacy" on the bottom of our
internet home page. You may also print a copy of the Notice by
clicking on Notice of Privacy Practices – English version / Spanish version.
For further information, please view these documents: