Privacy Request

You can make a privacy request if you want to get a copy of your health information or limit how your information is shared with other organizations.

• To request that the Alliance does not electronically share your health information with other organizations, fill out the Health Information Exchange (HIE) Opt-Out Form.
• To get a copy of your protected health information from the Alliance, fill out the Record Access Request Form.

Read the instructions on how to download and fill out a form.

Open Health Information Exchange (HIE) Opt-Out Form

Open Records Access Request Form