Privacy of Your Health Information - Authorizations
To protect your privacy, we will talk only to you about your health information, unless:
- You tell us that we can talk to someone else.
- We are required or it is legally okay to talk to someone else.
If you want us to talk about your health information to a family member or friend, you must give us a signed release form. Download and use the form to authorize Community Health Plan to release your health information to someone else. You can also get a copy of the form by calling our Community Health Plan customer service team at 1-800-440-1561 (toll free) or emailing us at customercare@chpw.org. If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.
If you give us permission to share your health information with others, it is okay to change your mind later. You must tell us that you have changed your mind by sending a signed release form revoking your authorization so we know to stop sharing this information.
Notice of Privacy Practices
- Privacy and Security of Your Health Information
- Privacy of Your Health Information - Authorizations
- How We Use and Share Your Protected Health Information
- Protections for PHI Sent to Plan Sponsors
- Web Privacy Statement and Policy
- Your Rights About Your Protected Health Information
- How Do I Use My Rights?
- Can I Opt Out of Certain Disclosures?
- How Do I Ask Questions or Report a Problem?
- Rights and Privacy Policies and Procedures

