The Student Health Center is committed to providing high quality health care to the Canisius community. Protecting your personal health information is primary to providing quality care.
The Student Health Center maintains and protects your personal health information in many ways. The Health Center does not release personal health information to anyone without your written authorization. This means that faculty, family members, coaches, employers, etc. will not be given any information unless you give the Health Center written permission to disclose your personal health information. The Authorization for Disclosure of Health Information is available in the Forms section of this web site for that purpose.
The Student Health Center does not honor a release request to disclose all medical treatment to a parent/guardian. Students must complete the Authorization for Disclosure of Health Information each time they receive care and treatment in the Student Health Center.
Authorizations expire within six months or after the information has been released.
The Health Center staff is trained annually on federal and state mandates that apply to personal health information. Staff members are trained on disclosure procedures and the consequences for unauthorized disclosures.
All personal health information is maintained in locked files in the Health Center. There is limited access to those files. Staff members who have a need to review your records in the course of their duties have been trained on confidentiality procedures. The Health Center itself is secured at the end of each workday.
In the event of a life threatening illness or injury or if you are taken to the hospital, the Director of Student Health or a college designee will notify your designated emergency contact.
How to Obtain a Copy of Medical Information, Physical Examination Form and/or Immunization Records
Complete and submit the Authorization for Disclosure of Health Information form to the Student Health Center. Be sure the form indicates what records you are requesting, dates of service (ex: physical examination and immunization records dated 2/14/2002; medical evaluation in Student Health Center rendered 9/10/2006 through 10/15/2006) and the full name and complete address, including zip code, of the individual who is receiving the information. The Student Health Center will not release information if the disclosure request is not clear or complete.
If you have had a name change, be sure to include the name you used while a student at the college and your college identification number,or your social security number and date of birth.
Record copies will be ready for pick up or mailed out one week ( 7 days ) after receipt of a properly completed authorization form.
Students will be given only one free copy of their physical examination form and immunization records. Additional copies will be subject to a per page charge of $0.75.
Students will be charged $0.75 per page to copy medical evaluation and treatment records.