HIPAA Information

FERPA

Data Security

Forms

Telework Risk Assessment

Forms

Augusta University takes privacy rights seriously. The following forms are necessary to assist with a variety of situations involving privacy.

Confidentiality Statement

 

Protecting personal records is of utmost importance. Augusta University prohibits unauthorized access or disclosure.

Disclosure Declaration-Breach Mitigation

 

If you receive health information or other confidential information you did not request, please complete this form.

Privacy Incident Intake Report

Report a privacy incident to Compliance, Ethics & Risk Management.

Fax Transmittal Cover

 

Please use this cover sheet when faxing confidential health care information.

Law Enforcement Request for PHI

 

When receiving a request for information from law enforcement, please complete this form and adhere to its guidelines.

Report Lost or Stolen Device

 

If you're not able to locate a device containing sensitive data, please complete this form as soon as possible.