Our Commitment to Patient Privacy
Each time a patient sees a physician, is admitted to a hospital, undergoes outpatient testing, fills a prescription with a pharmacist or sends a claim to a health plan, a record is made of the patient's health information. Until 1996, the confidentiality of patient health information was protected by a patchwork of state laws, which, some people argued, left gaps in the protection of patients' privacy and confidentiality. As part of the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), Congress recognized the need for national standards for patient privacy. As a result of HIPAA's mandate, the U.S. Department of Health and Human Services (“DHHS”) issued national patient privacy and security standards in 2000. In follow up to the Health Information Technology for Economic and Clinical Health Act (the “HITECH Act”), which was passed as part of the American Recovery and Reinvestment Act of 2009, DHHS updated those national patient privacy and security standards in 2013.
The privacy of patient health information has always been a high priority of Wolfson Children's Hospital and Florida law has for many years included significant patient privacy protections. This section of our web site is intended to provide our patients and their families with information about their privacy rights and our commitment to protect those rights. The information in this section of our web site will be updated in the event that our privacy practices change in the future.
Our Patient Privacy Practices
Wolfson Children's Hospital insists that our staff observe patient confidentiality and respect our patients’ right to privacy of health information. Please download the following documents for detailed information on our privacy practices (in PDF format):
- Summary of Privacy Practices
- Complete Notice of Privacy Practices
- Covered Entity Subsidiaries
- Non-discrimination Policy
Authorization to Share Medical Information with Others
There may be situations in which you want your Wolfson Children's Hospital medical provider to share information with third parties, such as your family members, loved ones, your other caregivers or attorney. If so, please download the appropriate document below (in PDF format). Otherwise, please let your healthcare team know, and they can assist you in the proper procedure for giving your consent to share specific information with specific people.
- Authorization to Release Medical Information and Radiology Images
- Authorization for Release of Information for Psychiatric & Psychological Care
- Authorization to Obtain Psychotherapy Notes
- Authorization for Release of Psychotherapy Notes
Request to Restrict the Sharing of Medical Information with Others
You may ask Wolfson Children's Hospital not to use or disclose medical information about you for certain purposes, as further described in the Wolfson Children’s Hospital Notice of Privacy Practices.
Disclosures to Health Plan
You may ask Wolfson Children's Hospital not to disclose medical information to your health plan in certain circumstances for tests, services or healthcare items for which you paid out of pocket in full. You may request a restriction on such disclosures to your health plan by downloading and completing the following form(s) (in PDF format):
Wolfson Children's Hospital is not required to agree to a restriction on other types of disclosures (other than the health plan restriction described above), and even if such a restriction is agreed to by Wolfson Children's Hospital it may ignore such restriction in an emergency. You may request a restriction on other types of disclosures by downloading and completing the following form(s) (in PDF format):
- Request to Restrict Use and Disclosure of Protected Health Information
- Baptist Connect Private Health Information Exchanges Patient Electronic Health Opt Out Form
Other Patient Privacy FormsAttorney's Certification for Subpoena Compliance