You have the following rights under state and federal law:
Copy of record: You may request to inspect the personal health record FBJ has generated about you. We may charge you a reasonable fee for copying and mailing your record.
Release of Records: You may consent in writing to release your records to others, for any purpose you choose. This could include your attorney, employer, or others who you wish to have knowledge of your care. You may revoke this consent at any time, but only to the extent no action has been taken in reliance on your prior authorization.
Restriction of Record: You may ask us not to use or disclose part of the personal health information. This request must be in writing. FBJ is not equired to agree to your request if we believe it is in your best interest to permit use and disclosure of the information. The request should be given to the Practice Manager who will consult with the staff involved in your care to determine if the request can be granted.
Contacting You: You may request that we send information to another address or by alternative means. We will honor such a request as long as it is reasonable and we are assured it is correct. We have a right to verify that the payment information you are providing is correct. Due to agency policy, we are not able to provide information by e-mail.
A signed medical records release request must be received by our office before we will release your records. You can print and complete the form here and:
- Hand Deliver to our office
Flagstaff Bone and Joint (Records Request Department)
77 W. Forest Ave. Ste 301
Flagstaff, AZ 86001
- Fax: (928) 773-2281