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Privacy Center

Trillium is vigilant about safeguarding your privacy. The following resources are designed to help protect your health information. If you have questions or need further information, please contact us

Trillium is also intersted in your privacy and has put togethere the following resources together for your use and information. Please let us know if you have any questions about this information as we are here to help answer your questions when you have them.

Important Privacy Information

Privacy Forms

  • Appointment of Representative
    Used to appoint someone to act on your behalf with regard to your health information
  • Authorization to Disclose Protected Health Information- English | Spanish
    Used to authorize Trillium to use or disclose your health information
  • Revocation of Authorization to Disclose Protected Health Information- English | Spanish
  • Request to Access (See) Records- English | Spanish

Other Information

See the Notice of Privacy Practices for details on how Trillium protects your information and your rights regarding this information.

Your Health Information Is Protected By Federal Law

Most of us believe that our medical and other health information is private and should be protected, and we want to know who has this information. The Privacy Rule, a federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. The Privacy Rule applies to all forms of individuals' protected health information, whether electronic, written, or oral. The Security Rule is a federal law that requires security for health information in electronic form.

Who Must Follow These Laws

We call the entities that must follow the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations"Covered Entities."

Covered entities include:

  • Health Plans
  • Health Care Providers
  • Health Care Clearinghouses
  • In addition, Business Associates of Covered Entities must follow parts of the HIPAA regulations.

What Information Is Protected

  • Information your doctors and other health care providers put in your medical record.
  • Conversations your doctor has about your care or treatment with nurses and others.
  • Information about you in your health insurer's computer system.
  • Billing information about you at your clinic.
  • Most other health information about you held by those who must follow these laws.

Privacy Concerns or Complaints

You may also report Privacy Concerns or Complaints to the Office of Civil Rights

U.S. Department of Health and Human Services
2201 Sixth Avenue - M/S: RX-11
Seattle, WA 98121-1831
Voice Phone: (800) 368-1019
FAX: (206) 615-2297
TDD: (800) 537-7697