Notices

Privacy Notices

Kaleida Health Notices

• Notice of Privacy Practices (PDF)
• Notice of Privacy Practices (Spanish) / Aviso de Próctica de Privacidad (PDF)

Organized Healthcare Arrangement

Kaleida Health, Erie County Medical Center Corporation, General Physician, PC, Olean General Hospital, Bradford Regional Medical Center, Visiting Nursing Association of Western New York, Millard Fillmore Surgery Center, Southtowns Surgery Center, Brooks-TLC Hospital System, and Cuba Memorial Hospital participate in an Organized Health Care Arrangement ("OHCA"). This allows us to share health information to carry out treatment, payment and joint health care operations relating to the OHCA, including shared storage or management of your information, health information exchange, financial and billing services, insurance, quality improvement, and risk management activities.

Authorizations

• Individual Authorization for the Use and Disclosure of Protected Health Information (PDF)
  
• Individual Authorization for the Use and Disclosure of Protected Health Information (Spanish)/ Autorización Individual Para El Uso y Revelación de la Información de Salud Protegida (PDF)
• Authorization for Release of Health Information and Confidential HIV-Related Information (PDF)
• Authorization for Release of Health Information (Including Alcohol/Drug Treatment and Mental Health Information) and Confidential HIV/AIDS-related Information (PDF)

Last updated: 03/02/2022