top of page

NJ Privacy Officer Contact

Address: 35 East Tioga Street Tunkhannock, PA 1865718411
Phone: (570) 996-6288

Email: privacyofficer@eihab.org

 REQUEST ACCESS TO YOUR CLINICAL INFORMATION  

To request access to your clinical information or to request any of the rights listed here, complete the form below.

Your Relation

Thanks for submitting!

NOTE: Other regulations may restrict access to HIV/AIDS information, federally protected education records, and federally protected drug and alcohol information. See any special authorizations or consent forms that will specify what information may be released and when, or contact the Privacy Officer listed above.

COMPLAINT

If you believe your privacy rights have been violated, you may file a complaint below.

Your Relation

Thanks for submitting!

bottom of page