Amendment Request Form : For asking the GIC to amend erroneous or incomplete protected health information created and maintained by the GIC.
Confidential Communication Form : For personal safety reasons, form to request alternative GIC communication delivery.
Request to Inspect and Copy Form : For requesting a copy of protected health information created and maintained by the GIC.
Privacy Complaint Form : For lodging a complaint with the GIC on how the GIC handled your protected health information.
Accounting of Protected Health Information Disclosure Form : For requesting an accounting of the GIC's disclosures of protected health information on or after April 14, 2003.
Authorization Form For Release of Health Information : For authorizing GIC representatives to disclose or receive your protected health information with persons you designate.
Request to Restrict Access Form : For requesting to restrict the GIC's use or disclosure of protected health information.
This information provided by the Group Insurance Commission .
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