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Privacy Policies, Procedures and Forms

Client Requests for Confidential/Alternative Communications

▪  Policy HHSA L-05

▪  Procedure L-05

▪  Form HHSA 23-05 English

▪  Form HHSA 23-05 Spanish

▪  Form HHSA 23-05 Tagalog

▪  Form HHSA 23-05 Arabic

▪  Form HHSA 23-05 Vietnamese

▪  Form HHSA 23-05 Farsi

▪  Form HHSA 23-05 Chinese

▪  Form HHSA 23-05 Dari

▪  Form HHSA 23-05 Korean

▪  Form HHSA 23-05 Somali

Provision and Acknowledgement of Notice of Privacy Practices

▪  Policy HHSA L-06

▪  Procedure L-06

HIPAA Authorization/Release of Information

▪  Policy HHSA L-09

▪  Procedure L-09

▪  Form HHSA 23-09 English

▪  Form HHSA 23-09 Spanish

▪  Form HHSA 23-09 Tagalog

▪  Form HHSA 23-09 Arabic

▪  Form HHSA 23-09 Vietnamese

▪  Form HHSA 23-09 Farsi

▪  Form HHSA 23-09 Chinese

▪  Form HHSA 23-09 Dari

▪  Form HHSA 23-09 Korean

▪  Form HHSA 23-09 Somali

Minimum Necessary Uses and Disclosures

▪  Policy HHSA L-16

Client Complaints and Non-Retaliation

▪  Policy HHSA L-18

Privacy & Security Training, Statement, and Certification

▪  Policy HHSA L-22

▪  Procedure L-22

Privacy and Contracts

▪  Policy HHSA L-23

▪  Procedure L-23

Privacy Incident Reporting

▪  Policy HHSA L-24

▪  Procedure L-24

Use and Disclosure of Protected Health Information

▪  Policy HHSA L-25

▪  Procedure L-25

▪  Procedure - Addendum L-25

▪  Procedure L-25-19 – Uses and Disclosures During Local Emergencies

Safeguarding Protected Information 

▪  Policy HHSA L-26

▪  Procedure L-26

De-Identifying Protected Information and Limited Data Sets

▪  Policy HHSA L-21

▪  Procedure L-21

Legal Authority for Privacy Decisions

▪  Policy HHSA L-27

Privacy Definitions 

▪  Policy HHSA L-30