Notice of Privacy Practices

Review for information regarding how medical information about you may be used and disclosed, and your rights as an individual.

Authorization Form

If you would like to permit Midlands Choice to speak with another person, such as a family member, about your health information, print, complete, and return this form to Midlands Choice.

Request for Access

If you would like to obtain a copy of your health information or have a copy of your health information directed to a third party, please print, complete, and return this form to Midland Choice.