Turn on more accessible mode
Turn off more accessible mode
Skip Ribbon Commands
Skip to main content
Search
Welcome to the County of Berks
  • Elected Officials
    • Commissioners
    • Clerk of Courts
    • Controller
    • Coroner
    • District Attorney
    • Prothonotary
    • Recorder of Deeds
    • Register of Wills
    • Sheriff
    • Treasurer
    • Elected Officials List
  • DepartmentsCurrently selected
  • Municipalities
  • Police Departments
  • Fire Companies
  • EMS
  • How Do I...
You are here: Berks County > County Departments > Human Resources > HIPPA Forms
  • Home
  • Affirmative Action
  • Benefits
  • Employment Opportunities
  • HIPAACurrently selected
  • Links
  • Exit Interview
HIPPA Forms

Authorization for the Release of Health Information

Client Complaint Regarding Management of Protected Health Information

Client's Request for Access to Own Medical Record

Client Request to Amend Protected Health Information

Notice of Privacy Practices

Request for Accounting of Disclosures

Request for Alternate Communication

Request to Restrict Use or Disclosure of Protected Health Information

Website Login
Forgot My Password 
Subscribe/Register