You have the following rights regarding protected health information we maintain about your child:

Right to Inspect and Copy. You have the right to inspect and request a copy of your child's protected health information, except as prohibited by law.

To inspect and/or request a copy of your child's protected health information that may be used to make decisions about your child, you must submit your request in writing.  If you request a copy of the information, we may charge a reasonable fee to offset the costs associated with the request.

We may deny your request to inspect and copy in certain circumstances.  If you are denied access to certain protected health information, you may request that the denial be reviewed.  Another licensed health care professional chosen by the hospital will review your request and the denial.  The person conducting the review will not be the person who denied your request.  We will comply with the outcome of the review. 

Right to Amend.  If you feel that protected health information we have about your child is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the hospital. To request an amendment, your request must be made in a writing that states the reason for the request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

• was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
• is not part of the protected health information kept by or for the hospital;
• is not part of the information which you would be permitted to inspect and copy; or
• is accurate and complete.

Right to an Accounting of Disclosures. You have the right to request one free accounting every 12 months of the disclosures we made of protected health information about you. To request this list, you must submit your request in writing. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper or electronically).  For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. 

Right to Request Restrictions. You have the right to request a restriction or limitation on the protected health information we use or disclose about your child for treatment, payment or health care operations. You also have the right to request a limit on the protected health information we disclose about your child to someone who is involved in your child's care or the payment for your child's care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery your child had.

We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide your child emergency treatment.

To request restrictions, you must make your request in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply.

Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. 

To request confidential communications, you must make your request in writing. We will not ask you the reason for your request. We will accommodate all reasonable requests.  Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of This Notice.  You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. 

To obtain a paper copy of this notice, contact:
            The Children's Center
            Attn:  Sue Lawson, Privacy Officer
            6800 N.W. 39th Expressway
            Bethany, OK 73008                    Phone: (405) 789-6711

You may download a copy of this notice by clicking here.

CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or
changed notice effective for protected health information we already have about your child as well as any information we receive in the future. We will post a copy of the current notice in the hospital. The notice will contain on the first page, near the top, the effective date.  In addition, each time your child registers at the hospital for treatment or health care services we will make available to you a copy of the current notice in effect. 

AUTHORIZATION FOR OTHER USES OF PROTECTED HEALTH INFORMATION
Other uses and disclosures of protected health information not covered by this notice or the laws that apply to us will be made only with your written authorization.  If you provide us authorization to use or disclose protected health information about your child, you may revoke that authorization, in writing, at any time.  If you revoke your authorization, we will no longer use or disclose protected health information about your child for the reasons covered by your written authorization.  You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records of the care that we provided to you.

COMPLAINTS
If you believe your child's privacy rights have been violated, you may file a written complaint with the hospital or with the Secretary of the Department of Health and Human Services. 
To file a complaint with the hospital, write:
            The Children's Center
            Attn:  Sue Lawson, Privacy Officer
            6800 N.W. 39th Expressway
            Bethany, OK 73008                    Phone: (405) 789-6711

To file a complaint with the Secretary of the Department of Health and Human Services,
contact:

You will not be penalized for filing a complaint.