Effective Date: April 14, 2003

636 Valley Mall Parkway, East Wenatchee WA 98802
509-886-6318 / FAX 509-886-6320 / Toll Free 877-563-3678

The following "Notice of Privacy Practices" contains important information about how your medical information is used and protected by Chelan-Douglas Regional Support Network. Chelan-Douglas Regional Support Network provides funding to the following agencies where you may have accessed services:

• Catholic Family and Child Service 509-662-6761
• Columbia Valley Community Health Behavioral Health Services 509-662-7195
• Children’s Home Society of Washington 509-663-0034

Chelan-Douglas Regional Support Network maintains only a limited amount of medical information at its Region Office associated with your services and related billing information. Requests you might have for information associated with your services should be directed to the agency where you have accessed services.

This Privacy Notice is written and given to you to assist in understanding a new law called the Health Insurance Portability and Accountability Act (HIPAA), and includes the following information:

1. Introduction

2. How We Will Use and Disclose Your Health Information

3. Uses and Disclosures of Your Health Information with Your Permission

4. Your Rights Regarding Your Health Information

5. Complaints

6. Changes to this Notice

7. Who will follow this Notice

Crisis Line - 509-662-7105 or 1-800-852-2923