





The Patient Notification Process is a simple and basic part of providing patient rights regarding health information exchange under state and federal law.
The Patient Rights Process below provides instructions, FAQs and pre-fillable forms to assist healthcare providers in setting up the Patient Notification Process. In addition to the forms and education materials, Health Current provides hands-on assistance to providers to integrate an efficient and effective Patient Rights Notification Process into their operations and daily workflow.
Patient Rights Process Summary, Patient Notification Flow Chart, FAQs & Implementing the Patient Rights Notification Video
Click to download Summary of the Patient Rights Process
Click to download Patient Notification Process Flow Chart
Click to download Frequently Asked Questions (FAQs)
Click to download Implementing the Patient Rights Notification Video
The Notice of Health Information Practices (The Notice)
Click to download the Notice of Health Information Practices (Notice) in English
Click to download the: Notice of Health Information Practices (Notice) in Spanish
Patient Rights Process Video
The Patient Rights Process video can assist healthcare providers in setting up their patient notification process and provide education about patient rights under state and federal law.
Patient Rights Forms
A provider can download the following Patient Rights Forms. Each form is provided in a Generic or Pre-Fillable format to allow a provider or organization the ability to insert their contact information in the Provider Only section of the forms in addition to adding their logo or office address at the top of the form.
For Step-by-Step Instructions for using the Pre-Fillable forms below – Click here
Opt Out Forms
Opt Out Forms – English
Click to download the Generic Form
Click to download the Pre-Fillable & Logo Only Form
Click to download the Pre-Fillable & Textbox Only Form
Opt Out Forms – Spanish
Click to download the Generic Form
Click to download the Pre-Fillable & Logo Only Form
Click to download the Pre-Fillable & Textbox Only Form
Health Information Request Forms
Health Information Request Forms – English
Click to download the Generic Form
Click to download the Pre-Fillable & Logo Only Form
Click to download the Pre-Fillable & Textbox Only Form
Health Information Request – Spanish
Click to download the Generic Form
Click to download the Pre-Fillable & Logo Only Form
Click to download the Pre-Fillable & Textbox Only Form
Opt Back In Forms
Opt Back In Forms – English
Click to download the Generic Form
Click to download the Pre-Fillable & Logo Only Form
Click to download the Pre-Fillable & Textbox Only Form
Opt Back In Forms – Spanish
Click to download the Generic Form
Click to download the Pre-Fillable & Logo Only Form
Click to download the Pre-Fillable & Textbox Only Form
Patient Education Materials
This is a supplement to the Notice of Health Information Practices for patients with lower literacy level. Each form is provided in a Generic or Pre-Fillable format to allow a provider or organization the ability to insert their logo or office address at the top.
What You Need to Know About Secure Sharing of Your Health Information – English
Click to download the Generic Form
Click to download the Pre-Fillable & Logo Only Form
Click to download the Pre-Fillable & Textbox Only Form
What You Need to Know About Secure Sharing of Your Health Information – Spanish
Click to download the Generic Form
Click to download the Pre-Fillable & Logo Only Form
Click to download the Pre-Fillable & Textbox Only Form
State & Federal Law Statutes
Arizona Law HIO Statute – Click here to download
Arizona HIO Statute (Arizona Revised Statutes, Title 36, Chapter 38, Article 1, Sections 3801 – 3809)
Federal Law: 42 CFR Part 2 – Click here to download
For questions about any of the Patient Rights Process or as an HIE participant you need assistance in implementing your patient notification process, please contact Health Current at 602-688-7200 or email us at hiesupport@healthcurrent.org.