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Summaries & Acknowledgements, Notifications, Posters, Authorization Forms, and Miscellaneous

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Summary & Acknowledgement: San Francisco Department of Public Health Notice of Privacy Practices 

• Chinese (2 pgs)
• English (2 pgs)
• Russian (2 pgs)
• Spanish (2 pgs)
• Tagalog (4 pgs)
• Vietnamese (4 pgs)
  

DPH Notice of Privacy Practices - Long Version (How Medical Information About You May Be Used & Shared In the San Francisco Department of Public Health (DPH) & How You Can Get This Information.) 

• Chinese (8 pgs)
• English (8 pgs)
• Russian (10 pgs)
• Spanish (8 pgs)
• Tagalog (10 pgs)
• Vietnamese (10 pgs)
  

Poster

• Chinese (1 pg)
• English (1 pg)
• Russian (2 pgs)
• Spanish (1 pg)
• Tagolog (1 pg)
• Vietnamese (2 pgs)
  

Authorization for Release or Disclosure of Protected Health Information

• Chinese (1 pg)
• English (1 pg)
• Russian (1 pg)
• Spanish (1 pg)
• Vietnamese (1 pg)
  

Miscellaneous HIPAA Forms

• Authorization to Disclose Health Information: one part (front and back)
• Authorization to Disclose Health Information: three parts (for triplicate printing)
• Authorization to Disclose Health Information, Psychotherapy Notes
• Medical Record Amendment Request Form
• HIPAA Business Associate Addendum (Exhibit E, posted December, 2007)
  

DPH Privacy Policies

• DPH Privacy Policy, adopted March, 2003:
  Also refer to:
  • Summary - SFDPH Notice of Privacy Practices
  • Detail - SFDPH Notice of Privacy Practices
  • Privacy Policy Matrix for Sharing Patient Health Information Between Treatment Providers
• Administration Requirements Policy, adopted April 2003
• Authorization Policy, adopted April, 2003
• Conduct of Research Policy, updated January, 2008
• Patients Rights Policy, adopted April, 2003

DPH Data Security Policies

• DPH Electronic Data Security Policies – User Brief
  
  
• Access Control
• Confidentiality & Security Agreement, adopted January 16, 2007, updated December 28, 2007
• Continuity and Contigency
• Data Backup
• Data Classification
• Data Network
• Documentation and Accountability
• Malicious Software Prevention & Surveillance Policy Revised
• Media Disposal
• Network Administration
• Password

• Portable Computers

• Remote Access Policy, 2006

• Risk Analysis Management

• Secure Transmission of Protected Health Information, effective March 10, 2008
• Secure Storage, Disposal or Reuse of Media Containing Critical Data, effective March 10, 2008

• Security Tracking and Reporting

• Security Violation Sanctions Policy Revised

• Software Development

• Training and Awareness

• Wireless

• Workstation

Privacy Policy Matrix for Sharing Patient Health Information Between Treatment Providers (Updated April 27, 2007, Acrobat file, 1 pg)

Confidentiality & Security Agreement, adopted January 16, 2007, updated December 28, 2007

• User Confidentiality and Security Agreement Form: Use of SFDPH Records and Information Systems

DPH Safety Net List (Updated May 11, 2007, Acrobat file) If you have a question about whether or not a particular provider is part of the DPH Safety Net, please phone 415-255-3569.

Training:

• DPH Privacy & Security Annual Update (Acrobat file and may be printed; updated June 11, 2008)
• DPH Privacy & Security Annual Update (File is for MS Powerpoint, if you have a dialup connection, downloading may be slow; updated June 11, 2008, and the content of this file is identical to the one above)