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 You may request that we provide you with a written accounting of all disclosures made by us during the time period for which you request (not to exceed 6 years). We ask that such requests be made in writing on a form provided by our agency. Please note that an accounting will not apply to any of the following types of disclosures; disclosures made for reasons of treatment, payment, or health care operations; disclosures made to you or your legal representative, or any other individual involved with your care; disclosures made pursuant to a valid authorization; disclosures to correctional institutions or law enforcement officials; and disclosures for national security purposes. You will not be charged for your first accounting request in any 12 month period. However, for any requests that you make thereafter, you will be charged a reasonable, cost-based fee. For more information about this right, see 45 C.F.R. § 164.528.
• You have the right to obtain a paper copy of our Notice of Privacy Practices upon request. You may also access and print a copy of our notice from our website.
• You may revoke an authorization to use or disclose health information, except to the extent that action has already been taken. Such a request must be made in writing.
For More Information or to Report a Problem
If you believe that your privacy rights have been violated, you may file a complaint with the Agency or with the Secretary of the Department of Health and Human Services. To file a complaint with the Agency contact:
5212 Rue Verdun Alexandria, LA 71303 318-484-4418
All complaints must be submitted in writing. You will not be penalized for filing a complaint.
If you have any questions about this Privacy Notice, please contact the Privacy Officer for the Agency:
5212 Rue Verdun Alexandria, LA 71303 318-484-4418
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