HIPAA Information

FERPA

Data Security

Forms

Telework Risk Assessment

Contact Us

Compliance, Ethics & Risk Management

Health Sciences Campus

Annex I

3000Q

706-721-0900

706-721-1910

compliance@augusta.edu


Third Party Hotline:
1-800-576-6623

Submit Online Report

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 Form

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.