Patient Information

At EPHC, our patients are our number one concern. We want you to know your rights regarding the privacy of your medical records, and we encourage you to take advantage of your ability to craft an advance health care directive/living will.

to fill out and print Patient Annual Clinic Paperwork

para rellenar y imprimir el Papeleo Anual del Paciente

Health Information Privacy

The privacy of your personal medical information is our utmost concern. For information on patient Health Information Privacy and Security (HIPAA) laws, go to The U.S. Department of Health and Human Services enforces the HIPAA Security Rule protecting your health information and setting national standards for the security of your electronic health records.

The Notice of Privacy Practices describes how your medical information may be used and disclosed and how you can get access to this information.

You can request a copy of your personal health record by printing and filling out our Release of Information (ROI) form, and returning it to Hospital Admitting, 500 1st Ave., Portola. For more information, contact Health Information Management: (530) 832-6506.

The Consent to Treat a Minor form is required of non-parent caregivers of minor children when a parent is not present.

Advanced Health Care Directive

An Advance Health Care Directive, or living will, enables you to fill out a form, or create your own, which allows you to do the following:

Follow the link below to the Advance Health Care Directive information offered by the California State Attorney General's Office. They offer a detailed explanation of what you might want to include in your individual Advance Health Care Directive.

To view the Advance Health Care Directive form and instructions created for your use by the California State Attorney General's Office, click the link below. You can fill out or amend this form to suit your personal needs.