For Your Protection. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Your Health Care Information is Private. Information that we collect about you and your health is personal. One of most important responsibilities is keeping your health care information private. You have the right to discuss your concerns about how your health information is shared with the Alaska Health Fair privacy officer. The law states the following: we must protect you health care information from others who do not need it, and you may ask us not to share certain health care information, though we may not be able to agree with your request.

Who Sees and Shares my Health Care Information? Alaska Health Fair paid and volunteer staff may see your Health Fair participation forms for purposes of facilitating the health fair and for compiling numbers (data) about the health fair after it is over. Health Fair data is grouped and is not identifiable by individuals; we sometimes report aggregate numbers to our funding sources. Alaska Health Fair does not release any information on individual participants unless the participant signs and submits a request for us to do so, or as required by law (see below).The Alaska Health Fair lab manager reviews blood test results and makes calls to participants with high glucose or cholesterol results. Pathology Associates Medical Laboratory processes the Health Fair blood tests and will call any person with critical blood test screening results.

How is Payment Made? If a workplace is providing payment for the blood tests performed during a health fair, Alaska Health Fair will provide a list of the employees who participated at that specific health fair to the employer in order to receive payment for services provided. We do not bill third party payers.

May I See My Health Care Information? Alaska Health Fair provides each health fair participant with a copy of their health care information. Alaska Health Fair mails blood screening results to each participant who elects to have blood tests performed during a health fair. If you think some of your information is wrong, you may ask in writing that we correct or add to it. You may ask that the corrected or new information be sent to others who have received your health care information from us. You may ask us for a list of where we sent your health care information.

What if my Health Care Information Needs to go Somewhere Else? You may ask Alaska Health Fair to send your health care information to others. We will ask you to sign a separate authorization form permitting your health care information to go to them. The form tells us what, where and to whom the information must be sent.

Could my Health Care Information be Released Without My Authorization? Laws describe what health care information must be shared, even if you do not sign an authorization form. Most of these disclosures would never occur through Alaska Health Fair. The following types of information must be reported by law: contagious diseases, birth defects, cancer; firearm injuries; reactions to problems with medicines or defective medical equipment; to the police when required by law; when the court orders it; as required for Workers? Compensation; as required for Public Health; for the federal government when they are investigating something important to protect the country or the President; abuse, neglect and domestic violence, if related to child protection or vulnerable adults; for permitted research purposes, organ donations and serious threats to public health or safety.

How do I get a Copy of this Notice? This notice is yours. You may request a copy at any time.

Questions or Complaints? If you have questions or feel your privacy rights have been violated you may contact the privacy official by calling 907-278-0234 or by writing Alaska Health Fair, Inc. PO Box 221267 Anchorage, AK 99522 or by e-mailing ahfair@ak.net. You can also complain to the federal government Secretary of Health and Human Services or to the HHS Office of Civil Rights. Your health care services will not be affected by any complaint made to the AHF Privacy Officer, Secretary of HHS, or Office of Civil Rights.