Notice of Privacy Practices

Notice of Privacy Practices (PDFs):

• Notice of Privacy Practices - English
• Notice of Privacy Practices - Spanish
• Notice of Privacy Practices - Russian
• Notice of Privacy Practices - Arabic
• Notice of Privacy Practices - Simplified Chinese (Mandarin)
• Notice of Privacy Practices - Traditional Chinese (Cantonese)

Cleveland Clinic Forms

• Request for Restrictions on Use and Disclosure of Protected Health Information form
• Request for Amendment of Health Information form
• Authorization to Disclosure Health Information

Cleveland Clinic Health System & Affiliated Facilities

Cleveland Clinic Main Campus

Cleveland Clinic Family Health Centers and other locations where health care services are rendered by Cleveland Clinic employees, including Avon - Richard E. Jacobs Health Center, Avon Lake Family Health Center, Avon Pointe Family Health Center, Beachwood Family Health and Surgery Center, Brunswick Family Health Center, Chagrin Falls Family Health Center, Elyria Family Health and Surgery Center, Independence Family Health Center, Lakewood, Lakewood Family Health Center, Lorain Family Health and Surgery Center, Solon Family Health Center, Stephanie Tubbs Jones Health Center, Strongsville Family Health and Surgery Center, Twinsburg Family Health and Surgery Center, Willoughby Hills Family Health Center, Wooster Family Health Center

Cleveland Clinic Regional Hospitals in Northeast Ohio: Avon Hospital, Euclid Hospital, Fairview Hospital, Hillcrest Hospital, Lutheran Hospital, Marymount Hospital, Medina Hospital, South Pointe Hospital

Cleveland Clinic Children’s Hospital for Rehabilitation in Northeast Ohio

Cleveland Clinic Home Care Services

Cleveland Clinic Affiliates in Northeast Ohio, including Ashtabula Regional Medical Center, Ashtabula Regional Home Health, Glenbeigh Hospital

Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas, NV

Cleveland Clinic affiliated locations in Florida: Cleveland Clinic Florida, Cleveland Clinic Florida – West Palm Beach, Krupa Center, Palm Beach Gardens, Parkland, Weston Family Health Center; Cleveland Clinic Florida Concierge Medicine

Organized Health Care Arrangements

Cleveland Clinic currently participates in one or more Organized Health Care Arrangements involving the following parties:

• Northern Ohio Trauma System (NOTS)
• Cleveland Clinic Canada
• Cleveland Clinic Abu Dhabi
• Physicians and other caregivers who are independent practitioners in Cleveland Clinic regional hospitals and affiliated hospitals

Health Information Exchange

Cleveland Clinic currently participates in health information exchanges (HIE’s), which ultimately help enhance the quality of your care.

The goal of the HIE’s is to help participating physicians and providers give better, more efficient care to their patients by the sharing of health information across secure systems. This means that wherever a patient goes, the patient’s health information may be available to all doctors who use the HIE’s, which helps to provide safer, more coordinated patient care.

Cleveland Clinic currently utilizes Care Everywhere, eHealth Exchange and Clinisync to access and share your health information with other participants of these HIE’s for treatment purposes and for payment of treatment services. These HIE’s allow any health information organization that participates in the HIE’s to have secure electronic access to patients’ records.

You may opt out of the health information exchanges by doing one of the following:

1. Click on the link to fill out the form to opt-out: Care Everywhere Opt Out Form

OR

2. Mail your written request, signed, and dated to the Cleveland Clinic Office of Corporate Compliance and Business Ethics, 6801 Brecksville Rd, RK-50, Independence, OH 44131

Requesting patients should include all the following information with your written request so we can be sure to identify the correct medical information to opt-out from all the Health Information Exchanges that Cleveland Clinic participates in:

1. First and last name (and middle name, if applicable)
2. Cleveland Clinic medical record number
3. Date of birth
4. Address
5. Phone Number

Questions: Contact the Cleveland Clinic Privacy Office at 216.444.1709 (toll-free 800.223.2273, ext. 41709)

NOTICE: If you send health information to Cleveland Clinic via email, please know that your message may be sent in an unencrypted email. An unencrypted email means there is a risk that the information in the email and any attachments could potentially be read by a third party when it is sent through the internet.