North Country Community Mental Health

To access services, call 1-800-834-3393 or TTY/TDD: dial 711
24-Hour Crisis Help Line: 1-800-442-7315

North Country Community Mental Health covers Antrim, Charlevoix, Cheboygan, Emmet, Kalkaska and Otsego Counties.

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Privacy Notice

Effective April 14, 2003
Revised July 24, 2018


This notice describes how personal and medical information about you may be used and disclosed and how you can get access to this information. Please read carefully.

Our Privacy Commitment to You
We care about your privacy. The information we collect about you is private. We are required to give you a notice of our privacy practices. Only people who have both the need and the legal right may see your information. We may disclose your information without your permission when necessary for the purposes of treatment, coordination of care, payment, health care operations or when we are required to by law. In all other cases we will get your written consent prior to releasing information.

Changes to this Notice
We reserve the right to revise this notice. A revised notice will be effective for medical information we already have about you as well as any information we may receive in the future. We are required by law to comply with whatever notice is currently in effect.

How to Use Your Rights Under This Notice 
If you want to use your rights under this notice, you must make your requests in writing. We will help you prepare your written request if you wish. Please use the contact information below for assistance. If you would like a copy of your records, please contact the clerical staff at the NCCMH office where you receive services to complete a request for records.

See 42 USC 290dd-2 for federal law and 42 CFR Part 2 for federal regulations governing Confidentiality of Alcohol and Substance Use Patient Records.

Copies of this Notice
You have the right to receive an additional copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. Please call or write to us to request a copy.

 

Contact Info:

PRIVACY OFFICER
Phone: 231-439-1268
TTY: 711
FAX: 231-439-8752
Email: recipientrights@norcocmh.org

NCCMH
Attention: Privacy Officer
1420 Plaza Drive
Petoskey MI, 49770