ECU Authorization for Use or Disclosure of PHI

ECU Authorization for Use or Disclose of PHI (Spanish)

ECU Individual Request for PHI (Revised 2/2010)

ECU Individual Request for PHI (Spanish)

ECU Privacy Complaint Form

ECU Privacy Complaint Process

ECU Request for Amendment of Protected Health Information

ECU Request for Alternate Communication

ECU Request for Accounting of Disclosures of PHI

ECU Accounting of Disclosure Log 

ECU Accounting of Disclosures Log for 50 or More Individuals 

ECU Request for Restriction on the Use & Disclosure of PHI (Revised 2/2010)

ECU Business Associate Agreement  (Revised 4/2013)

ECU Notice of Privacy Practices (English Revised 9/2012)

ECU Notice of Privacy Practices (Spanish Revised 9/2012)


Data Use Agreement