I may revoke this authorization at any time by providing a written notice to Rand Recovery Homes, LLC. The revocation will not apply to information already released based on this authorization before the date of revocation.
Rand Recovery Homes, LLC may not condition services on my decision to sign this authorization unless the provision of care is related to the information to be disclosed.
Information disclosed under this authorization may be subject to re-disclosure by the recipient and may no longer be protected by HIPAA or Minnesota state law.
7. Privacy Practices
I acknowledge that I have received, read, and understood Rand Recovery Homes, LLC's Notice of Privacy Practices, which explains how my personal and health information may be used and disclosed. I understand that the Notice of Privacy Practices can be updated, and I may request the latest version at any time.
8. Client Rights Under HIPAA and Minnesota State Law
I have the right to access my health information and request corrections.
I have the right to an accounting of disclosures of my health information.
I understand that under Minnesota law, health and mental health records may not be released without my written consent, except under specific legal conditions.
9. Signature and Consent
By signing below, I authorize Rand Recovery Homes, LLC to release and/or obtain the specified information as outlined above. I understand my rights under HIPAA and Minnesota state privacy laws, and I am aware that I may revoke this authorization at any time.