Request Your Medical Record (PDF) - Boulder Community Hospital
Request Your Medical Record (PDF) - Boulder Community Hospital
Request Your Medical Record (PDF) - Boulder Community Hospital
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In accordance with 42 C.F.R. Section 2.13, any disclosure of information from a federally assisted<br />
drug or alcohol abuse program must be limited to that information which is necessary to carry out<br />
the purpose of the disclosure.<br />
Pursuant to 42 C.F.R. Section 2.32, the following statement on the prohibition of redisclosure<br />
must accompany each disclosure made with the patient's written consent:<br />
PROHIBITION ON REDISCLOSURE<br />
This information has been disclosed to you from records protected by Federal confidentiality<br />
rules (42 C.F.R. Part 2). The Federal rules prohibit you from making any further disclosure of<br />
this information unless further disclosure is expressly permitted by the written consent of the<br />
person to whom it pertains or as otherwise premitted by 42 C.F.R. Part 2. A general authorization<br />
for the release of medical or other information is NOT sufficient for this purpose. The Federal<br />
rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug<br />
abuse patient.