Health Information Services Privacy Complaint Form

On March 20, 2003, the Office of Civil Rights (OCR) for the Department of Health and Human Services (HHS) published a notice explaining how to file a health information privacy complaint with the civil rights office. OCR has authority to receive and investigate complaints against covered entities related to the privacy rule.  Complaints to OCR must be filed in writing (either on paper or electronically), name the entity that is the subject of the complaint and describe the acts or omissions believed to be in violation of the applicable requirements of the privacy rule, and be filed within 180 days of when individuals realized that the act or omission occurred. OCR may extend the 180-day period if a person demonstrates good cause. Any alleged violation must have occurred on or after April 14, 2003, for OCR to have the authority to investigate. OCR recommended that individuals submitting complaints use the OCR Health Information Privacy Complaint Form.