Forms & Resources

Notice of Nondiscrimination

St. Joseph Hospital, St. Joseph Hospital Physician Practices and its affiliates comply with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

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Patient Rights

St. Joseph Hospital is committed to providing quality health care and to protecting the information contained in your medical record. This notice describes how your health information may be used and disclosed and how you can get access to this information.

Privacy Policies

Our Online Privacy Policy

  • Information gathered by voluntary user submission
  • Information gathered by our web server
  • Contact information

If you have any questions or require additional information, please contact St. Joseph’s Corporate Compliance Office at (603) 884-3824.

Accessing Your Patient Medical Record

While patient medical records are the property of St. Joseph Hospital, under federal privacy law you have numerous rights with respect to the information maintained in those records. You also have the right to access your medical record and to request copies. After you review, you can always request that information be revised or corrected. All of these rights are subject to some exceptions that are described fully in the Notice of Nondiscrimination.

  • Uses or disclosures of your health information
  • Our policy regarding your protected health information

For a full description of the uses and disclosures we are permitted to make, consult the Notice of Privacy Practices. We are required to provide you with our Notice of Privacy Practices and to abide by its terms. We may amend the Notice from time to time. All amendments apply retroactively.

Click here to view our Notice of Privacy Practices.

  • How we may use or disclose your PHI
  • Uses or disclosures made pursuant to your verbal agreement
  • Uses or disclosures permitted by law
  • Uses or disclosures required by law
  • Uses or disclosures that require your written authorization
  • Your rights regarding your health information

St. Joseph Hospital is permitted to use and disclose your health information under a variety of circumstances. In most cases, we must obtain your authorization before we use or disclose protected health information. There are some circumstances that do not require this type of proactive authorization. Common reasons we will disclose protected health information include:

  • Providing information about your health condition to others who may treat you;
  • Obtaining payment from your health plan for the treatment that we provided;
  • Reporting a communicable disease, domestic violence or criminal activity; or
  • Complying with a court order requiring the disclosure of your medical record.

Forms

We’re here to assist you with any needs you have related to your care. We’ve provided some common forms below to make life easier on our patients and on community and referring providers.

Medical Record Release >

Permission to Speak/Authorization to Discuss PHI >

603-882-3000
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