All patients must sign an Acknowledgement of Receipt of Notice of Privacy Practices. The KTHFS Notice of Privacy Practices outlines how information about you may be disclosed. We encourage our patients to carefully read this important document.

Please note: If you decide you would like to share your protected health information with another individual or healthcare facility, you will need to sign the KTHFS Form 810: Authorization to Use and/or Disclose Protected Health Information or the KTHFS Form 810 BH Authorization to Use and/or Disclose Protected Health Information for Behavioral Health Records. This form becomes a part of your medical record. Non-KTHFS Authorizations for Use and/or Disclosure of Protected Health Information are not accepted.

Forms may be mailed or faxed to:

Attn: Medical Records Department
c/o KTHFS Wellness Center
PO BOX 490
Chiloquin, OR 97624

Medical Records:
Fax: 541.783.3273

 

KTHFS Compliance Program

Klamath Tribal Health & Family Services (KTHFS) is committed to supporting a “culture of compliance.”
A compliance program is a system of internal controls designed to ensure that health care providers like KTHFS regularly evaluate and monitor their own adherence to applicable laws, regulations, and program requirements.

Compliance programs serve as a mechanism for preventing and reporting breach of laws and regulations that fall within certain criteria such as Medicare, Medicaid, HIPAA, OSHA and others. Our commitment to compliance is communicated to employees through the KTHFS Code of Ethics, Employee Standards of Conduct, and Compliance Program policy and procedures. To report a compliance concern, please contact:

Compliance Administrator
Klamath Tribal Health & Family Services
3949 S. 6th Street
Klamath Falls, OR 97603

Compliance Helpline:
Tel: 541.882.1487 ext. 215