SHANDS - UF Privacy Office - University of Florida

Changes to This Notice
We reserve the right to change this notice at any time.
We reserve the right to make the revised or changed
notice effective for medical information we already have
about you as well as any information we receive in the
future. We will post a copy of the current notice in
Shands HealthCare and the UF Health Science Center
facilities. The effective date of this notice will be listed
on the first page, in the top right-hand corner of the
document.
Complaints
If you believe your privacy rights have been violated, you
may file a complaint with us or with the Secretary of the
Department of Health and Human Services. You will not
be penalized for filing a complaint.
To file a complaint with Shands HealthCare, contact
Shands HealthCare’s Privacy Officer, Compliance
Department, PO Box 103175, Gainesville, FL 32610-
3175, or phone toll-free at 1-866-682-2372. To file
a complaint with the about the UF Health Science
Centers, write to the University of Florida Privacy
Office at PO Box 100014, Gainesville, FL 32610-
0014 or phone toll-free at 1-866-876-4472. All complaints
must be submitted in writing on the appropriate
form that will be provided upon request.
To file a complaint with the Secretary of the Department
of Health and Human Services, contact the Office of
Civil Rights, Medical Privacy, Complaint Division,
U.S. Department of Health and Human Services,
200 Independence Avenue, SW, HHH Building,
Room 509H, Washington, DC 20201, Phone toll-free:
1-866-627-7748; TTY: 1-886-788-4989; Email through the
Internet: www.hhs.gov/ocr
SHANDS
HealthCare
UNIVERSITY OF
FLORIDA
3/5/03 15-9053-0