Accounting of Disclosures (Who has accessed my records?):
- PDF ‐ https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/patient‐request‐for‐an‐accounting‐of‐disclosures‐12‐2017.pdf
- DocuSign; Complete and sign electronically ‐ https://na4.docusign.net/Member/PowerFormSigning.aspx?PowerFormId=7ebda72b-e3ed-42ee-a03a-193b5813d04b&env=na4&acct=afca22f4-29c3-47c9-9f74-67e7cea8e0f3&v=2
Request for Amendment of the Medical Record (A change, edit or update of medical record information that you believe is incorrect):
- PDF ‐ https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/request‐for‐amendment‐of‐medical‐record.pdf
- DocuSign; Complete and sign electronically ‐ https://na4.docusign.net/Member/PowerFormSigning.aspx?PowerFormId=e43cf273-7ccb-4970-8dcf-d420d4402527&env=na4&acct=2ec878a0-6b02-4532-a4c6-29103d2d9a93&v=2
Request to Limit the Use or Release of Records (I do not authorize Denver Health to use/disclose to a person or entity):
- PDF ‐ https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/restriction‐on‐use‐and‐disclose‐of‐patient‐health‐information‐approved‐final‐‐‐8.pdf
- DocuSign; Complete and sign electronically ‐ https://powerforms.docusign.net/b9f3b471‐2cc8‐41a2‐8b48‐3dff3de8c88b?env=na4&acct=afca22f4‐29c3‐47c9‐9f74‐67e7cea8e0f3
Medical Durable Power of Attorney (Healthcare planning document appointing your healthcare agent in medical decision making):
- PDF English ‐ https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/f50‐255‐medical‐durable‐power‐of‐attorney.pdf
- PDF Spanish – https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/power‐of‐attorney/spanish‐medical‐durable‐power‐of‐attorney‐spanish
- PDF Amharic – https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/power‐of‐attorney/amharic‐medical‐durable‐power‐of‐attorney
- PDF Arabic – https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/power‐of‐attorney/arabic‐medical‐durable‐power‐of‐attorney
- PDF Dari – https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/power‐of‐attorney/dari‐medical‐durable‐power‐of‐attorney
- PDF Russian – https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/power‐of‐attorney/russian‐medical‐durable‐power‐of‐attorney
- PDF Vietnamese ‐ https://www.denverhealth.org/‐/media/files/patients‐visitors/medical‐records/power‐of‐attorney/vietnamese‐medical‐durable‐power‐of‐attorney