Tewksbury Hospital Your Information. Your Rights. Our Responsibilities. Your Rights 365 East Street This notice describes how Tewksbury, MA 01876-1998 medical information about you www.mass.gov/locations/tewksbury-hospital may be used and disclosed and how you can get access to this information. Please review it carefully. When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. Get an electronic You can ask to see or get an electronic or paper copy of your medical or paper copy of record and other health information we have about you. Ask us how to do this. your medical record We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Ask us to correct You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. your medical record We may say to your request, but we’ll tell you why in writing “no” within 60 days. Request You can ask us to contact you in a specific way (for example, home or confidential office or to send mail to a different address. communications We will say to all reasonable requests. “yes” continued on next page
Tewksbury Hospital Your Rights 365 East Street Tewksbury, MA 01876-1998 www.mass.gov/locations/tewksbury-hospital Your Information. Your Rights. Our Responsibilities. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. Get an electronic or paper copy of your medical record You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Ask us to correct your medical record You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days. Request confidential communications You can ask us to contact you in a specific way (for example, home or office or to send mail to a different address. We will say “yes” to all reasonable requests. continued on next page
tewksbury-privacy-practices.docx