This notice describes how medical [including mental health] information about you may be used and disclosed and how you can get access to this information. Please review it carefully and let us know any questions that you may have concerning this notice. During the process of providing services to you, Community Reach Center will obtain, record, and use mental health and medical information about you that is protected health information. Community Reach Center will not use or disclose more information for payment purposes than is necessary. This is known as using only the minimum necessary amount to accomplish the purpose of use or disclosure. We are accountable to the Secretary of Health and Human Services to safeguard (keep secure) and protect (keep private) our Consumers’ information. Ordinarily that information is confidential and will not be used or disclosed, except as described below.
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View or download the entire NOTICE OF PRIVACY RIGHTS document (english)
View or download the entire NOTIFICACIÓN SOBRE SUS DERECHOS DE PRIVACIDAD document (Spanish)
In order to request medical records from Community Reach Center, please complete the Request to Access Protected Health Information (PHI) form below:
Copies of medical records may be released to a third party (someone other than the consumer) upon receipt of a valid Release of Information (ROI) authorized by the consumer or guardian/legal representative. To authorize the release of records to a third party, please complete the form below:
Fees or charges may apply, but we will notify you of any applicable fees before we process your request. Custody/guardianship must be confirmed to establish authority prior to a records release. Please include necessary legal paperwork when submitting your request. If you are seeking verbal disclosures for care coordination purposes, please contact the treatment team directly or by calling Community Reach Center’s main phone number at 303-853-3500. Completed forms (and applicable legal paperwork) can be submitted to Community Reach Center’s Medical Records Department by:
In person: At any of our Community Reach Center locations