HIPAA Privacy Rights

Request Data Deletion

Under HIPAA (45 CFR § 164.526), you have the right to request amendment or deletion of your Protected Health Information. Complete this form and our Privacy Officer will review your request within 30 days.

Important: Some records cannot be fully deleted due to legal retention requirements. Scope of Appointment records must be retained for 10 years per CMS regulations. Audit logs must be retained for 6 years per HIPAA. In these cases, your personal identifying information will be redacted while the record structure is preserved.

This number was provided in your confirmation email or can be obtained by contacting us at [email protected].

By submitting this form, you certify that you are the individual whose information is contained in the record, or an authorized representative. False requests may be subject to legal action.

For immediate assistance, contact our Privacy Officer at [email protected] or call (800) 555-0165.