
Evergreen is committed to protecting your privacy and the privacy of your health information.
The Health Insurance Portability and Accountability Act (HIPAA) gives Evergreen the right to use and disclose your health information for treatment, payment and certain health care operations purposes without specific authorization from you.
It also grants you these specific rights regarding your health information:
Right to request access to or a copy of your health information. We will ask that you make your request specific and in writing. We may charge a reasonable fee for the cost of producing and mailing the copies. In certain situations, we may deny your request and will tell you why we are denying it. In some cases, you may have the right to ask for a review of our denial.
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Right to request an amendment to your health information if you believe our records are incomplete or inaccurate. Your request for amendment must be in writing and provide the reason for your request. In certain cases, we may deny your request. If so, we will notify you in writing. You may respond by filing a written statement of disagreement with us and ask that the statement be included with your health information.
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Right to request restrictions by asking that we limit the way we use or disclose your medical information for treatment, payment, or health care operations. You may also ask that we limit the information that we give to someone who is involved in your care, such as a family member or friend. We are not required to agree to your request. If we do agree, we will honor your restriction unless it is an emergency. We may ask you to make your request in writing.
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Right to request that we communicate with you by another means to preserve confidentiality. For example, if you want us to communicate with you at a different address or telephone number we can usually accommodate your request if it is reasonable.
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Right to seek an accounting of certain disclosures by asking us in writing for a list of the disclosures we have made of your health information, except for disclosures for treatment, payment, health care operations, information provided to you, facility directory listings, certain government functions, and disclosures made prior to April 14, 2003.
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Right to receive a paper copy of our Notice of Privacy Practices (PDF). We will offer you a copy of our notice the first time you register or present for treatment or health care services at Evergreen Healthcare. You may also request a copy of this notice at any time or obtain a copy on our website. This notice lists all the different ways that we might use or disclose your health information and provides you with information about exercising your various rights.
If you have questions relating to the protection of your health information or Evergreen Healthcare's privacy practices, please contact :
Sheila Green-Shook
Evergreen Hospital Privacy Officer
Phone: 425.899.1939
Email: SGreen-Shook@evergreenhealthcare.org
12040 NE 128th Street Kirkland, WA 98034
Or call Evergreen at 425.899.3000 for information
Or call the Evergreen Healthline at 425.899.3000
Press "1" at the prompt
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