Home | Provider Resources | About Us | Contact Us | Search

Privacy Practices

Community Care is committed to keeping your personal information private and secure.

This Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. We encourage you to review it in detail.

Notice of Privacy Practices     English (59K, PDF) | Español (66K, PDF)

Member Request Forms

Request to have Protected Health Information sent to a Private Mailing Address

Allegheny | Carbon/Monroe/Pike | Chester | North Central | North East | York | Adams | Berks

Request to Access Protected Health Information

Allegheny | Carbon/Monroe/Pike | Chester | North Central | North East | York | Adams | Berks

Request to Amend Protected Health Information

Allegheny | Carbon/Monroe/Pike | Chester | North Central | North East | York | Adams | Berks

Request to Restrict Use and Disclosure of Protected Health Information

Allegheny | Carbon/Monroe/Pike | Chester | North Central | North East | York | Adams | Berks

Request Personal Representative Designation

Allegheny | Carbon/Monroe/Pike | Chester | North Central | North East | York | Adams | Berks

Request an Accounting of Disclosed Protected Health Information

Allegheny | Carbon/Monroe/Pike | Chester | North Central | North East | York | Adams | Berks

Request to Revoke an Authorization for Release of Information Form

Allegheny | Carbon/Monroe/Pike | Chester | North Central | North East | York | Adams | Berks