Submit the form below. Call 888-213-2147 ext zero with any questions.
Opt Out Request Form (Spanish)
The same federal health information privacy protections that apply to paper information also apply to electronic health records. CCHIE complies with the Federal Health Insurance Portability and Accountability Act (HIPAA). Patients have the right to “opt-out” of CCHIE anytime which means healthcare providers cannot search for your medical information. You may choose to participate again at any time.
Revoke Opt Out
Submit this form to revoke a previous opt out request.
Revoke Opt Out Request Form
Revoke Opt Out Request Form (Spanish)
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Privacy and Security Policies