HIPAA Notice of Privacy Practices doc format of    hipaa2013noticeofprivacypractices.doc  : Comprehensive list of GIC enrollee privacy rights.

Amendment Request Form pdf format of    HIPAAAMENDMENTrequestFORM.pdf  : For asking the GIC to amend erroneous or incomplete protected health information created and maintained by the GIC.

Confidential Communication Form pdf format of    HIPAACONFIDENTIALCOMMUNICATIONFORM.pdf  : For personal safety reasons, form to request alternative GIC communication delivery.

Request to Inspect and Copy Form pdf format of    HIPAAINSPECTANDCOPYFORM.pdf  : For requesting a copy of protected health information created and maintained by the GIC.

Privacy Complaint Form pdf format of    HIPAAprivacyCOMPLAINTFORM.pdf  : For lodging a complaint with the GIC on how the GIC handled your protected health information.

Accounting of Protected Health Information Disclosure Form pdf format of    HIPAAprothealthinforequestform.pdf  : 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 pdf format of    HIPAAreleaseofinfoauthorizationFORM.pdf  : For authorizing GIC representatives to disclose or receive your protected health information with persons you designate.

Request to Restrict Access Form pdf format of    HIPAAREQUESTTORESTRICTFORM.pdf  : For requesting to restrict the GIC's use or disclosure of protected health information.


This information provided by the Group Insurance Commission.