HIPAA Privacy Statement

Notice of privacy practices this notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Please review it carefully.

If you have any questions about this notice, please contact our Privacy Officer at (570) 387-2128.

This notice describes our Hospital's practices and that of:

When this notice refers to Hospital, it is referring to the Geisinger-Bloomsburg Hospital and members of its medical staff (including your physician(s)).

This Notice applies only to protected health information created or obtained in connection with medical care provided to you in the Hospital. It does not apply to care provided to you in your physician's office or in the office of any other healthcare provider. If you have not previously visited your physician's office, upon your next visit you should receive that physician's Notice of Privacy Practices as it relates to his or her own office practice.

Notice of Privacy Practices

We understand that medical information about you and your health is personal. We are committed to protecting medical information or protected health information (PHI) about you. We create a record of the care and services you receive at the Hospital. We need this record to provide your care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by the Hospital, whether made by Hospital personnel or your personal doctor. Your personal doctor may have different policies or notices regarding the doctor's use and disclosure of your medical information created in the doctor's office or clinic.

This notice will tell you about the ways we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

We are required by law to:

How We May Use and Disclose Medical Information About You.

The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

Special Situations

Your Rights Regarding Medical Information About You.

You have the following rights regarding medical information we maintain about you:

Forms and preaddressed, postage paid envelopes are available for you to use to submit your specific requests about your rights to our Privacy Officer.

Change to This Notice

We reserve the right to change this notice. 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 the Hospital. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register at or are admitted to the Hospital for treatment or healthcare services as an inpatient or outpatient, we will offer you a copy of the current notice in effect.


If you believe your privacy rights have been violated, you may file a complaint with the Hospital. To file a complaint with the Hospital, contact our Privacy Officer. All complaints must be submitted in writing.

Or to file a complaint with the Secretary of Health and Human Services:

You will not be penalized for filing a complaint.

Other Uses of Medical Information

Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission, in writing, you may revoke that permission at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and we are required to retain our records of the care that we provided to you.