How Do I Use My Rights?
To use your rights you must fill out the right form and mail it to the Privacy Officer at:
Community Health Plan
Attn: Privacy Officer
720 Olive Way, Suite 300
Seattle, WA 98101
To use your protected health information rights, download and fill out the form you need:
- Authorization to Release Health Care Information
- Request to Access Your Protected Health Information (PHI)
- Request to Correct Your Protected Health Information (PHI)
- Request for an Accounting of Disclosures of Your PHI
- Request to Restrict Disclosures of Your Protected Health Information (PHI)
You may also request the form be sent to you by calling our Community Health Plan customer service team at 1-800-440-1561 (toll free) or email us at customercare@chpw.org. If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.
Notice of Privacy Practices
- Privacy and Security of Your Health Information
- Privacy of Your Health Information - Authorizations
- How We Use and Share Your Protected Health Information
- Protections for PHI Sent to Plan Sponsors
- Web Privacy Statement and Policy
- Your Rights About Your Protected Health Information
- How Do I Use My Rights?
- Can I Opt Out of Certain Disclosures?
- How Do I Ask Questions or Report a Problem?
- Rights and Privacy Policies and Procedures