Privacy Statement


Understanding Your Health Record/Information
This notice describes the practices of Memorial Hermann Surgical Hospital and that of any physician1 with staff privileges with respect to your protected health information created while you are a patient here. Memorial Hermann Surgical Hospital, physicians with staff privileges, and personnel authorized to have access to your medical chart are subject to this notice. In addition, Memorial Hermann Surgical Hospital and physicians with staff privileges may share medical information with each other for treatment, payment or health care operations described in this notice.

We create a record of the care and services you receive at Memorial Hermann Surgical Hospital. We understand that medical information about you and your health is personal. We are committed to protecting medical information about you.

This notice applies to all of the records of your care at Memorial Hermann Surgical Hospital. This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

Your Health Information Rights
Although your health record is the physical property of Memorial Hermann Surgical Hospital, the information belongs to you. You have the right to:

Request a restriction on certain uses and disclosures of your information for treatment, payment, health care operations and as to disclosures permitted to persons, including family members involved with your care and as provided by law. However, we are not required by law to agree to a requested restriction;

  • Obtain a paper copy of this notice of information practices;
  • Inspect and request a copy of your health record as provided by law;
  • Request that we amend your health record as provided by law. We will notify you if we are unable to grant your request to amend your health record;
  • Obtain an accounting of disclosures of your health information as provided by law;
  • Request communication of your health information by alternative means or at alternative locations. We will accommodate reasonable requests; and
  • Revoke your authorization to use or disclose health information except to the extent that action has already been taken in reliance on your authorization.

You may exercise your rights set forth in this notice by providing a written request, except for requests to obtain a paper copy of the notice, to the Health Information Management Department at Memorial Hermann Surgical Hospital in writing at 1211 Highway 6, Ste. 70, Sugar Land, TX 77494.

Our Responsibilities
In addition to the responsibilities set forth above, we are also required to:

  • Maintain the privacy of your health information;
  • Provide you with a notice as to our legal duties and privacy practices with respect to information we maintain about you;
  • Abide by the terms of this notice;
  • Notify you if we are unable to agree to a requested restriction on certain uses and disclosures;
  • We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain, including information created or received before the change. Should our information practices change we are not required to notify you, but we will have the revised notice available for you to request at Memorial Hermann Surgical Hospital. The revised notice will also be posted at Memorial Hermann Surgical Hospital and at
  • We will not use or disclose your health information without your written authorization, except as described in this notice.

Examples of Disclosures for Treatment, Payment, Health Care Operations and As Otherwise Allowed By Law.
The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information should fall within one of the categories.

We will use your health information for treatment. For example: We may disclose medical information about you to doctors, nurses, technicians, medical students, or other personnel who are involved in taking care of you at Memorial Hermann Surgical Hospital. We may share medical information about you in order to coordinate different treatments, such as prescriptions, lab work and x-rays.

We may also provide your physician or a subsequent health-care provider with copies of various reports to assist in treating you once you are discharged from care at Memorial Hermann Surgical Hospital.

We will use your health information for payment. For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for regular health care operations.
For example: We may use the information in your health record to assess the care and outcome in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and services we provide.
We will use your health information as otherwise allowed by law. The following are some examples of how we may use or disclose medical information about you.

Business associates: There are some services provided in our organization through agreements with business associates. Examples include answering services and copy services. To protect your health information, however, we require business associates to appropriately safeguard your information.

Directory: Unless you notify us that you object, we will use your name, location in facility, general condition, and religious affiliation for directory purposes while you are a patient at Memorial Hermann Surgical Hospital. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name. Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.

Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to protect the privacy of your health information.
Funeral directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.

Organ procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Communications for treatment and health care operations: We may contact you to provide appointment reminders or information about treatment alternatives or other health related benefits and services that may be of interest to you.
Fundraising: We may contact you as part of a fundraising effort.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, medications, devices, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.

Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Abuse, neglect or domestic violence: As required by law, we may disclose health information to a governmental authority authorized by law to receive reports of abuse, neglect, or domestic violence.

Judicial, administrative and law enforcement purposes: Consistent with applicable law, we may disclose health information about you for judicial, administrative and law enforcement purposes.

Required or allowed by law: We will disclose medical information about you when required or allowed to do so by federal, state or local law.
For More Information or to Report a Problem
If you have questions and would like additional information, you may contact the Memorial Hermann Surgical Hospital Office of HIPAA Compliance at 214-407-5370.
If you believe your privacy rights have been violated, you can file a complaint with the Memorial Hermann Surgical Hospital Office of HIPAA Compliance or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.