HIPAA Policy at Restore

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As a care provider, we take patient HIPAA and privacy rights very seriously at Restore. It is thus important to us that patient’s know and understand their protective rights and are able to follow through with them if they so choose.

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Read about Restore’s Patient HIPAA Rights and Procedures: POL-3001

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Restore HIPAA Forms:

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• F1001 – HIPAA Health Record Request

• F1002 – HIPAA Health Record Correction-Amendment Request

• F1003 – HIPAA Restricted Communication Request

• F1004 – HIPAA Restricted Use Request

• F1005 – HIPAA Accounting of Disclosure Request

• F1006 – HIPAA Privacy Authorization

• F1007 – HIPAA Official Complaint

• F1008 – HIPAA Patient Health Record Disagreement

 

If you have any questions regarding your HIPAA rights as a patient at Restore or Restore’s HIPAA policy please contact our HIPAA Compliance Officer:

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Maria Kreher
Phone: 716.906.2102
Email: Manager@restoremedicalfitness.com

 

Restore Medical Fitness
Attn: HIPAA Compliance Officer
4545 Transit Rd.
Williamsville NY, 14221