Members

Privacy Forms and Descriptions Give MoreCare permission to discuss or disclose personal and health information or to share information/documents for a specific purpose

• Authorization to Disclose Protected Health Information (PHI) in Englishchevron_right
• Authorization to Disclose Protected Health Information (PHI) in Spanishchevron_right

Stop MoreCare from discussing or disclosing your personal health information with a previously authorized individual or group

• Protected Health Information (PHI) Revocation Request in Englilshchevron_right
• Protected Health Information (PHI) Revocation Request in Spanishchevron_right

Give permission to have your substance use treatment providers share information with other members of your health care team

• Authorization to Disclose Substance Use Disorder (SUD) Information in Englishchevron_right
• Authorization to Disclose Substance Use Disorder (SUD) Information Spanishchevron_right

Request an accounting of when MoreCare discloses your personal health information for reasons other than for Treatment, Payment, or Healthcare Operations, or for disclosures made with your authorization or permission

• Request for Accounting of Protected Health Information (PHI) in Englishchevron_right
• Request for Accounting of Protected Health Information (PHI) in Spanishchevron_right

Request an amendment to your health information maintained by MoreCare or entities on behalf of MoreCare

• Request to Amend Protected Health Information (PHI) in Englishchevron_right
• Request to Amend Protected Health Information (PHI) in Spanishchevron_right

Request that MoreCare restrict disclosures of your health information or request MoreCare provide your protected health information (PHI) by alternative means or at alternative locations

• Protected Health Information (PHI) Communication Request in Englishchevron_right
• Protected Health Information (PHI) Communication Request in Spanishchevron_right

Provides MoreCare permission to use your name and/or story in its Media, Educational or Promotional materials

• Member Authorization and Release for Promotional and Educational Activities in Englishchevron_right
• Member Authorization and Release for Promotional and Educational Activities in Spanishchevron_right