My child has
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice describes Cook Children's Health Care System's (CCHCS) practices and those of:
The following entities within Cook Children's Health Care System will follow these practices:
These entities, sites and locations follow the terms of this notice and may share protected health information with each other for treatment, payment or operational purposes described in this notice.
The term "you" in this notice represents either you or your child.
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
Ask us to correct your medical record
Request confidential communications
Ask us to limit what we use or share
Get a list of those with whom we’ve shared information
Get a copy of this privacy notice
Choose someone to act for you
File a complaint if you feel your rights are violated
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We also may share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information, unless you give us written permission:
In the case of fundraising:
How do we typically use or share your health information? We typically use or share your health information in the following ways.
Bill for your
We may use third party business associates to perform these functions. To
safeguard your protected health information, Cook Children's has agreements with these third parties that require them to appropriately protect your information.
How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
For more information, see:
Help with public health and safety issues
We can share health information about you for certain situations such as:
Comply with the law
Respond to organ and tissue donation requests
Work with a medical examiner or funeral director
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
Respond to lawsuits and legal actions
For more information, see: hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
Changes to the terms of this notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office and on our website.
801 7th Ave.
Fort Worth, TX 76104
Dec. 1, 2014
682.885.4000 | Contact Us | Legal | Privacy | Patients and Parents Rights and Responsibilities | Non-Discrimination Policy
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