Conditions of Treatment Form
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Policy No.: 6070
Effective Date: 03/17/03
Revised Date:
Revised Date:
Conditions of Treatment Form Policy
Basis for Policy
It is the policy of the University of Nebraska Medical Center (UNMC) to use and disclose protected health information in accordance with Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements and Executive Memorandum No. 27, HIPAA Compliance Policy.
Policy
The University of Nebraska Medical Center (UNMC) shall provide information to the patient and obtain general consent using the appropriate Conditions of Treatment Form prior to providing treatment or services.
Definitions
Protected Health Information (PHI) is individually identifiable health information. Health information means any information, whether oral or recorded in any medium, that:
- is created or received by UNMC; and
- relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.
Records containing PHI, in any form, are the property of UNMC. The PHI contained in the record is the property of the individual who is the subject of the record.
Protected health information excludes education records covered by the Family Educational Rights and Privacy Act (FERPA), and employment records held by UNMC in its role as employer.
Additional Information
- Contact Privacy Officer
- See Conditions of Treatment Form Procedures
This page maintained by dkp
This page updated on Monday, February 16, 2004, by dkp.