Notice of Privacy Practices

Notice of Privacy Practices-English
Notice of Privacy Practices-Spanish

Privacy Forms

Authorization/Notification to Disclose Personal Health Information-English
Authorization/Notification to Disclose Personal Health Information-Spanish
Request to Amend Personal Health Information
Request for Restriction on Disclosure of Personal Health Information
Request for Personal Representative
Change Revocation Request

Please note: Cigna Medical Group will not disclose confidential information without your authorization unless it is necessary to provide your treatment, pay your Medical Group claims, administer health benefits, support Cigna HealthCare programs or services, or as otherwise required or permitted by law. We will not, for example, give your confidential information to a credit agency, a telemarketer or a prospective employer. We will not sell, rent or license the confidential information you provide to us including any information you provide within our public Web sites unless you authorize it. The Privacy Notice that each Cigna Medical Group patient receives from his/her physician describes more fully how we use your information. You may also read a copy of the Cigna Medical Group Privacy Notice on this Web site.