Compass Clinical Associates, PLLC nd Place Urbandale, Iowa FAX

ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY

To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Privacy Office at this practice.. If you request

You have the right obtain your health information with limited exceptions. You must make a request in writing to obtain access to your health information. You may obtain a form

You must submit your request in writing to Jackie Young, Practice Manager, 410-956-6302 in order to inspect and/or obtain a copy of your child’s IHI.. Our practice may charge a

(You must make a request in writing to obtain access to your health information. You may obtain a form to request access by using the contact information listed at the end of

(You must make a request in writing to obtain access to your health information. You may obtain a form to request access by using the contact information listed at the end of

$0.50 for each page, $20 per hour for staff time (amount to be decided) to copy your health information, and postage if you want the copies mailed to you. If you request an

To inspect and obtain a copy of medical information that may be used to make decisions about you, you must submit your request in writing to the Washington Hospital Health