Health and Human Performance
Back to Privacy Policies

PATIENT PRIVACY / PLAN2PEAK, INC.

HIPAA rights and procedures.

Understand the choices available for your health information and find the form that fits your request.

Working copy for review. This page and its forms adapt earlier materials for Plan2Peak, Inc. Confirm the policy, contact details, and forms before public use.

YOUR RIGHTS

Choose what you need to do.

Access your records

Ask to inspect or obtain a copy of health information in a designated record set.

F1001

Request a correction

Ask for an amendment if you believe information in your record is incorrect or incomplete. You may submit a statement of disagreement if a request is denied.

F1002 · F1008

Choose how we contact you

Request confidential communications by an alternative means or at another location.

F1003

Request limits on use or disclosure

Ask for a restriction on certain uses or disclosures of your information.

F1004

Ask about disclosures

Request an accounting of certain disclosures of your health information.

F1005

File a complaint

Raise a privacy concern with Plan2Peak, Inc. You may also contact the U.S. Department of Health and Human Services Office for Civil Rights.

F1007

HOW TO MAKE A REQUEST

Download and complete the appropriate form below. For questions or to arrange a secure way to submit it, contact the HIPAA Compliance Officer. Do not include health records or a completed form in an ordinary email inquiry.

Plan2Peak, Inc. · Attn: HIPAA Compliance Officer
195 N Union Road, Williamsville, NY 14221
716-982-8061 · Peter@Plan2Peak.com