Notice of Privacy Policies & Practices (HIPAA)

The Health Center’s Notice of Privacy Practices is guided by the principles of Health Insurance Portability and Accountability Act (HIPAA) in accordance with the U.S. Department of Health and Human Services.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information as required by the Health Insurance Portability & Accountability Act (HIPAA). Please review it carefully.

Understanding Your Medical Records/Health Information

Every time you visit Student Health Services at Grambling State University a record of your visit is made. This record typically contains information about your symptoms, examinations, test results, medications you take, your allergies, and the plan of care for you, as well as other information that pertains to your health or demographics. This information is referred to as your health or medical record, and contains personal health information that state and federal laws regulate for the protection of your privacy.

Uses and Disclosures of Health Information

The staff of Student Health Services will use your information for:

  1. TREATMENT: All medical personnel involved in your care will have access to and document in your medical record. This includes the Health Services staff as well as referral physicians.
  2. PAYMENT: Your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated in order to pay for services rendered to you that involve initial treatment at the health center.
  3. HEALTH OPERATIONS: Your record may be used as necessary to support the regular health operations and management of Student Health Services, such as quality review, assessment of care, results of care, for educational or training purposes, budgeting, and financial reporting.
  4. BUSINESS ASSOCIATES: This includes entities that we contract to provide services for us. However, we require the same protection of your medical record from business associates.
  5. COMMUNICATION WITH FAMILY/OTHERS: Due to the nature of our field, we will use our best judgment when disclosing health information to a family member, other relatives, or any other person involved in your care or that you have authorized to receive this information. Please inform Health Services when you do not want a family member or other individual to have authorization to receive your information.
  6. RESEARCH/TEACHING/TRAINING : We may use your information for the purpose of research, teaching, and training. All research projects are subject to a special approval process.
  7. AS REQUIRED BY LAW: We may disclose health information to the following types of entities but not limited to:
    • Healthcare Oversight Agencies
    • Food and Drug Administration
    • Public Health or Legal Authorities charged with preventing or controlling disease, injury or disability
    • Law Enforcement agencies for reporting, investigations, etc.
    • Workers Compensation Agents
    • Organ & Tissue Donation Organizations
    • Military Command Authorities
    • Funeral Directors, Coroners and Medical Directors
    • National Security & Intelligence Agencies
    • Protective Services for the President and Others
    • To avoid a serious threat to the health/safety of a person/the public.
  8. OTHER USES AND DISCLOSURES: Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision.


Director of Student Health
Foster-Johnson Health Center
Grambling State University
403 Main Street, Box 4251
Grambling, LA 71245

Office of Civil Rights
U.S. Dept. of Health & Human
200 Independence Ave., S.W.
Room 509F, HHH Building
Washington, DC 20201