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For that reason, you may prefer to mail or fax your request form to us. You have the right to request to see and receive a copy of your PHI contained in clinical, billing and other records used to make decisions about you.
We may charge you the following fees when you request your records for your own personal use:. You can receive your records in any of the following ways, and you just need to let us know your preference by checking the applicable box in the request form:. You may request that we restrict the use and disclosure of PHI about you, but we are not required to agree to your requested restrictions except in limited circumstances further described in the UNCHCS Notice of Privacy Practices.
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You may request how and where we contact you about PHI. We will accommodate reasonable requests, but, when appropriate, may condition that accommodation on your providing us with information regarding how payment will be handled and your specification of an alternative address or other method of contact. You have the right to request that we make amendments to clinical, billing and other records used to make decisions about you.
We will evaluate and determine whether it is proper to comply with your request, and we will notify you in writing of whether we complied with your request.
Typically, your request will be processed within 60 days of receipt of your completed request form. We will let you know in writing if there is a delay. You have the right to receive a written list of certain disclosures we have made of PHI about you. If you request a list of disclosures more than once in 12 months, we can charge you a reasonable fee.
Chapel Hill , NC Sign In First Time User? You should then complete, sign, and submit your request form s to us in any of the following ways: 1.
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Fill in your Authorization form. HIM s. Sign and return your completed form via: E-mail Simply scan and attach your completed Authorization Form to: relmedinfo unchealth. Siler City NC UNC Wakebrook Sunnybrook Road Raleigh, NC Please note that the email you send to us may not be secure, and as a result, your personal information in the form may be exposed during transmission or while it resides in your email account or on your computer.
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For that reason, you may prefer to mail or fax your request form to us Obtaining a Copy of Your Medical Record or Bills You have the right to request to see and receive a copy of your PHI contained in clinical, billing and other records used to make decisions about you. If you or a loved one need support, you have many options here. Our group of psychiatrists, psychologists, and counselors provide compassionate support and symptom management for the challenges that often come with a cancer diagnosis.
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If you or your loved one is interested in speaking with a member of our counseling team, call to make an appointment. A complete list of support groups, classes and workshops is available on the Cancer Support Calendar. See our Resources for other local area support programs, and peer support programs- support services that connects anyone touched by any type of cancer with another person whose experiences with cancer are similar. Contact: Michelle Manning, mmanning unc.
More caregiver resources online at Caregivers.
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Support from hospice staff and volunteers. Parents meet separately. Contact: Meghan Fox, meghan. Contact: Ritchie Briggs, This is NOT a support group, rather, just a cool space to hang out with some folks who have experienced cancer treatment No need to RSVP, just show up! When: 1st Tuesday of every month, — PM.
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