For a CNDH patient relations specialist, please email PxTeam@Chickasaw.net or call (580) 272-1037, Monday-Friday, 8 a.m.-5 p.m.

Outpatient

Patient Privacy Information

The Notice of Privacy Practices outlines patient rights regarding his/her protected health information and how the Chickasaw Nation Department of Health (CNDH) uses and discloses such information. The Authorization for Release of Protected Health Information is the document completed by the patient or the patient’s legal representative for obtaining a copy of the patient’s health information.

The document has specific elements that must be completed prior to the request being fulfilled. Upon completion of the Authorization, please submit to the Chickasaw Nation Medical Center (CNMC) Health Information Management Department, 1921 Stonecipher Blvd., Ada, Oklahoma 74820. Please allow 7–10 business days to receive your requested health information.

Service Line
Phone Numbers
Phone: (580) 559-0712
Toll-Free: (800) 851-9136
Forms and Documents
Service Area
  • Chickasaw Nation Residents - This service is available inside the Chickasaw Nation's boundaries.
  • Chickasaws At-Large - This service is available outside the Chickasaw Nation's boundaries.
Other Information

Privacy Notices
HIPAA is the federal Health Insurance Portability and Accountability Act passed in 1996. It requires health plans to protect the confidentiality of personal medical records and limit the personal health information released to others.

The Chickasaw Nation has evaluated policies and procedures across the health system and has taken steps to enhance privacy and security procedures already in place.

Notice of Privacy Practices (Effective January 1, 2020)
This notice will outline how CNDH will maintain your privacy under HIPAA regulations, including CNDH's duties, how your protected health information may be used or disclosed and your rights in regard to your health information. It is important that you carefully read the notice to fully understand how CNDH protects your privacy.

Privacy Violations

Use the link below to report if you believe your privacy rights or other violations of the Privacy or Security Rules have occurred.

https://chickasaw.complianceprohealth.com/report/privacy

Amendments Request

Use the link below to request amendments to your medical records. You will need to provide certain information such as provider, date of service or be able to identify what information you are requesting be amended.

https://chickasaw.complianceprohealth.com/report/amendments

Privacy Restriction/Limitation Request

Use the link below if you wish to request a restriction or limitation on the use and disclosure of your protected health information.   Note: CNDH is not required to agree to your request.

https://chickasaw.complianceprohealth.com/report/restrictions

Locations

Chickasaw Nation Medical Center

1921 Stonecipher Blvd.

Ada, Oklahoma 74820

Phone: (580) 436-3980

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