Alberta Health Services Access and Disclosure Form

Request for access to the Health Information Form (PDF, 1 MB) All applications are subject to a basic fee of $25.00, which can be up to 20 pages, depending on the recording format, i.e. paper, electronic or microfilm record. Each additional page costs between 0.25 and 0.50 cents per page. Additional charges may apply. Fees are charged in accordance with the Health Information Act. The ISR provides for limited and specific circumstances in which a custodian bank may disclose your data to third parties without your consent. Examples include: A custodian bank is an organization or entity defined in paragraph 1(1)(f) of the ISR or designated in section 2 of the Health Information Regulations. Examples of caregivers include physicians, chiropractors, nurses, Alberta Health Services and Alberta Health. The Information and Privacy Commissioner of Alberta is an independent officer of the Legislative Assembly of Alberta who strives to protect access to information and the right to privacy of all Albertans. The Office of the Information and Privacy Commissioner (CSI) is the regulator responsible for ensuring compliance with the ISR by custodian and affiliated companies. Other legislation may provide for retention requirements for health information. For example, under the Hospitals Act (subsection 15(1)), hospitals must keep records of diagnosis and treatment for 10 years after the discharge date or 2 years after the patient reaches or would have reached the age of 18, whichever is longer.

An affiliate within the meaning of Article 1(1)(a) of the HIA is a person or entity employed by a custodian bank, or a natural or legal person who provides a service to a depositary as an agent, volunteer or student, or under a contract or agency relationship with the depositary. Examples of affiliates include a receptionist or recorder at a doctor`s office or a nurse who works for Alberta Health Services. If the trustee determines that there is a risk of harm as a result of a breach, the individual(s), the Alberta Information and Privacy Officer and the Secretary of Health must be notified in writing. Tips for completing the “Request Access to Health Information” form: The HIA does not explicitly talk about keeping records. Current retention obligations are determined by organizations designated as guardians or by universities of applied sciences for regulated health professions. If you have any questions about how long records are retained, contact the appropriate organization or university of applied sciences. The HIA requires administrators to protect the confidentiality and security of health information (section 60) throughout the life cycle of records, including during storage, but does not prescribe the means by which this should be done. Provides individually identifiable health information to patients, authorized agents, service providers and other third parties in accordance with health information Act.In in accordance with Alberta`s Health Information Act, it is a service that allows the sharing of individually identifiable health information with or without an individual`s consent. For detailed instructions, frequently asked questions, and forms, see Access and Disclosure | Alberta Health Services.

Section 8.2 of the Health Information Regulations sets out the factors that trustees must consider when determining whether the breach poses a risk of harm to an individual. The assessment of the damage must be made by the depositary. Learn more about the rules that govern and protect your health information in care or under the control of a custodian. If you do not have a current care relationship with a participating health professional under Option 1 or with Alberta Health Services under Option 2, you may contact Alberta Health to request a copy of your records. You will need to complete an Access to Health Information Request Form and send it to Alberta Health with a $25 processing fee. For more information on this option, see . B where to submit your form and payment, please contact the Alberta Health Freedom of Information and Protection of Privacy Office at 780-422-5111 or toll-free at 310-0000 and 780-422-5111. The ISR requires a custodian to notify as soon as possible, in accordance with the rules relating to the loss, unauthorized access or disclosure of health information in the custodian`s custody or control, whether there is a risk of harm to an individual as a result of the loss or unauthorized access or disclosure. The Health Information Act (HIA) strikes a balance between the protection of privacy and the proper sharing of information to provide health services and administer the health care system. For detailed instructions, frequently asked questions, and forms, see Access and Disclosure | Alberta Health Services. Alberta Health Attention: Health Information Act Help Desk P.O.

Box 1360, Station Main Edmonton, AB T5J 2N3 Under the ISR, you have the right to request a correction or modification of the facts contained in your health information. To do this, you must make a written request to the custodian who keeps or controls the file. Within 30 days of receiving your request, the custodian must make the correction or change or inform you of the reason why the correction or addition was rejected. Notice to the Minister of Health (PDF, 175 KB) Please note that 2 pieces of identification are required to complete this application. Make a photocopy of your Alberta ID card or driver`s licence and personal health care number and submit copies with your form. Consent to Disclosure Form – Section 34 (PDF, 16 KB) Your first step should be to consult a participating health care professional with whom you have a current care relationship (p.B. Your gp or pharmacist) and ask to see or receive a copy of your file. You can request to complete an access to health information form and pay a $25 processing fee to process this information. The custodian to whom you submit the request depends on the option under which you request access (e.B. Your doctor or Alberta Health). If you do not have a current caregiver relationship with a participating health professional under Option 1, but you do have a current caregiver relationship with Alberta Health Services (AHS), such as .B. after recently being treated at an AHS hospital, you can request a copy of your record from AHS.

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