PURPOSE OF THIS POLICY

The Health Network Privacy Policy describes how personal medical information may be used and disclosed and how you can get access to this information.

POLICY STATEMENT

Health Records

Medical and mental health records (protected health information – PHI) are not included in the general university record keeping system. Health records are maintained in compliance with federal and Colorado privacy and retention regulations. A confidential health record is created for you upon proof of immunizations, receipt of off-campus medical records and/or after your first visit to the Colorado State University Health Network.

A copy of the privacy practices for the CSU Health Network can be obtained here.

If you are under 18 years of age:

• If you are under 18 years of age, your parent(s) or legal guardian(s) must sign an Authorization for Treatment of a Minor, which is kept in your electronic health record.

Prior Health History

• If an incoming student has a chronic medical condition, we recommend their doctor’s office send a copy of pertinent medical records to the CSU Health Network.
• Additionally, be sure to complete the Health History form online.

Releasing Your Health Information

• Protected health information cannot be released without your written consent/authorization unless authorized by law. If a patient is 18 years of age or older, we cannot release any information without his/her consent, even to parents. This information includes diagnosis, appointment history, test results, and billing information. A Consent/Authorization to Access or Release Protected Health Information form is available if you would like to release your PHI. This form must be filled out in person at the CSU Health Network or contact us regarding faxing/mailing this form.
• To have health information shared with parents, professors, etc., an Information Exchange form needs to be completed. This form must be filled out in person at the CSU Health Network or contact us regarding faxing/mailing this form.

POLICY PROVISIONS

Patient Rights & Responsibilities

Your patient rights and responsibilities at the CSU Health Network:

You have the RIGHT:

• To be treated with respect, consideration, and dignity
• To be provided with personal privacy, safety and security within the health network.
• To communicate in your primary language whenever possible if you are not fluent in English.
• To be provided, to the degree known, information concerning your diagnosis, evaluation, treatment and prognosis.
• To be informed and participate in treatment decisions, know the benefits, side effects, and possible complications of treatment
• To choose your providers and know the names and professional status of those working with you
• To privacy and confidentiality of your health information and health records
• To receive emergency care without waiting for authorizations or fearing financial penalty.
• To receive a privacy notice to inform you about how protected information will be disclosed
• To request that uses and disclosure of protected health information be restricted
• To consent to or refuse any care or treatment
• To be informed about services and any related costs
• To receive appropriate referrals to other providers and services
• To file a complaint against a provider, the facility, or healthcare personnel without fear of reprisal
• To be provided with help that will facilitate informed healthcare decisions in spite of language barriers, physical or mental disability, or difficulty understanding the care plan

To be provided reasonable access to care within the health network’s mission and scope of service regardless of:  Ethnicity, Race, Age Gender Identity and Expression, Disability, Culture, Different Ideas and Perspectives, First Generation Status, Marital Status, Geographic Background, Religious and Spiritual Beliefs, Sex, Sexual Orientation, Socioeconomic Status, Veteran Status, or National Origin.

You have the RESPONSIBILITY:

• To seek healthcare promptly
• To give accurate information about your health history regarding health, medications, including over-the-counter products and dietary supplements, and allergies or sensitivities.
• To ask questions or for clarification about anything you do not understand
• To report any significant changes in symptoms or failure to improve
• To respect CSU Health Network policies
• To treat all CSU Health Network staff with courtesy and respect
• To arrive for appointments at or before scheduled appointment time, keep appointments or cancel in a timely manner
• To provide useful feedback about our services and policies
• To know the names, purpose, and effects of medications prescribed to you
• To pay promptly any bills you have incurred
• To follow the treatment plan prescribed by the provider and participate in the care
• To provide responsible transportation and care for 24 hours when required by the provider
• To inform the provider about the existence of a living will, medical power of attorney or other advance directive that could affect your care.

FORMS AND TOOLS

Download the Consent/Authorization to Access or Release Protected Health Information Form

APPROVALS

Version 1.01 approved June 4, 2018 by Lynn Johnson, Vice President for University Operations