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The following documents regarding medical information are available here for downloading:
- Medical Record Release Information
- Low Vision Medical Record Release Information
- Pupillary Distance Release Statement
- HIPAA Statement
- Nondiscrimination Statement
- Patient Rights
- Privacy Statement
- Confidential Communication Request
- Privacy Complaint
- Request to restrict uses and disclosures of personal health information (PHI)
- Accounting Request
- Consultation Request
HIPAA Officers:
Matt Jewett
HIPAA Privacy Officer
614-292-5565
OPT-HIPAAPrivacyandSecurityOfficer@osu.edu
Alex Vu
HIPAA Security Officer
614-292-8186
OPT-HIPAAPrivacyandSecurityOfficer@osu.edu