Fort Hays State University > About FHSU > Division of Student Affairs > Kelly Center > Confidentiality And Privacy
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! If you consent, Fort Hays State University (FHSU) is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, diagnoses, treatment and applying for future care or treatment. It also includes billing documents for those services. Examples of uses of your health information for treatment purposes are:
An example of use of your health information for payment purposes:
An example of use of your health information for health care operations:
Your Health Information Rights The Health record we maintain and billing records are the physical property of FHSU. The information in it, however, belongs to you. You have a right to:
You have a right to review the Notice before signing the consent authorizing use and disclosure or your protected health information for treatment, payment, and health care operations purposes. If you want to exercise any of the above rights, please contact: Kenton L. Olliff, Assistant Vice President for Student Affairs / Director Kelly Center Fort Hays State University 600 Park Street Hays, KS 67601 (785) 628-4401 in person or in writing, during normal hours. He will provide you with assistance on the steps to take to exercise your rights. Our Responsibilities FHSU is required to:
We reserve the right to amend, change or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the notice by calling and requesting a copy of our “Notice” or by visiting our office and picking up a copy. To Request Information or File a Complaint If you have questions, would like additional information or want to report a problem regarding the handling of your information, you may contact: Kenton L. Olliff, Assistant Vice President for Student Affairs / Director Kelly Center Fort Hays State University 600 Park Street Hays, KS 67601 (785) 628-4401 Additionally, if you believe your privacy rights have been violated, you may file a written complaint at our office by delivering the written complaint to: Kenton L. Olliff, Assistant Vice President for Student Affairs / Director Kelly Center Fort Hays State University 600 Park Street Hays, KS 67601 (785) 628-4401 You may also file a complaint by mailing it or e-mailing it to the Secretary of Health and Human Services in Washington, DC.
Other Disclosures and Uses Business Associates
Communication with Family
Organ Procurement Organizations
Food and Drug Administration (FDA)
Abuse and Neglect
For Specialized Governmental Functions
Effective Date: April 14, 2003
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