HIPAA and Your Privacy Rights

Client information at DSS is protected by federal and state laws and regulations. This section contains copies of these laws and regulations, the DSS Privacy Policy and official DSS forms related to your privacy rights.

Privacy Documents

  Notice of Privacy Practices (English) (PDF 62KB)

  Notice of Privacy Practices (Versión en Español) (PDF 73KB)

  Authorization of Disclosure of Information (MS-Word)

  Request for Access to Protected Health Information (MS-Word)

  Request to Restrict Use/Disclosure of Protected Health Information (MS-Word)

  Request for Amend Protected Health Information (MS-Word)

  DSS Confidentiality Statute Sec. 17b-90 (MS-Word)

  DSS Privacy Regulation-TFA (MS-Word)

  DSS Privacy Regulation-SAGA (MS-Word)

  DSS Privacy Regulation-Other Programs (MS-Word)