Patient Information

Health Practices Information

Understanding Your Health Record/Information

Each time you visit a healthcare provider, a record of your visit is made. Typically, this record contains your identification, symptoms, examination and test results, diagnosis, treatment and a plan for future care or treatment. This information is contained in your medical record and serves as a:

  • Basis for planning your care and treatment
  • Means of communication among many health professionals who contribute to your care
  • Legal document describing the care you received
  • Means by which an insurance company can verify that services billed were actually provided
  • Tool in educating health professionals
  • Source of data for medical research
  • Source of information for public health officials charged with improving the health of the nation
  • Source of data for facility planning and marketing
  • Tool with which we can assess and continually improve the care and outcomes we achieve


Although your health record is the physical property of the NMSU Campus Health Center, the information belongs to you. According to 45 CFR 164.522, you have the right to:

  • Request a restriction on certain uses and disclosures of your information
  • Inspect and be provided with a copy of your health record
  • Add an amendment to your health record
  • Obtain an accounting of disclosures of your health information
  • Request communications of your health information by alternative means or at alternative locations
  • Revoke your authorization to use or disclose health information except to the extent that action has already been taken


The Campus Health Center is required to:

  • maintain the privacy of your health information
  • provide you with a notice (this document) as to our duties and practices with respect to information we collect and maintain about you
  • abide by the terms of this notice
  • notify you if we are unable to agree to a requested restriction

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will amend this notice to reflect those changes. We will not use or disclose your health information without your authorization, except as described in this notice.


If you have questions and would like additional information, you may contact the Associate Director of the Campus Health Center at 646-8305. If you believe your privacy rights have been violated, you can file a complaint with the Director or with the Secretary of Health and Human Services.

Patient Rights & Responsibilities

Patient Rights

The Campus Health Center of New Mexico State University adopts and affirms as departmental policy the following rights and responsibilities of patients who receive services at our facility. This policy affords you, the patient, the right to:

  1. considerate and respectful care;
  2. the identity and function, upon request, of all healthcare personnel; and healthcare institutions authorized to assist in your treatment;
  3. obtain from the person responsible for your healthcare, complete and current information concerning your diagnosis, treatment, and expected outcome in terms you can reasonable be expected to understand. When it is not medically advisable to give such information to you, the information shall be made available to an appropriate person on your behalf;
  4. receive information necessary to give informed consent prior to the start of any procedure and/or treatment except for emergency situations. This information shall include, as a minimum, an explanation of the specific procedure or treatment itself, its value and significant risks, and an explanation of other possible treatment methods, if any;
  5. information regarding advanced directives and/or ethical issues of patient care;
  6. refuse treatment and to be informed of the medical or other consequences of your action;
  7. privacy to the extent consistent with adequate medical care. Case discussions, consultations, examination and treatment will be confidential and conducted discreetly;
  8. privacy and confidentiality of all records pertaining to your treatment, except as otherwise provided by law or third party payment contract, and as outlined in the Notice of Health Information Practices
  9. a reasonable response to your request for services customarily rendered by this facility, and consistent with your treatment;
  10. expect reasonable continuity of care and to be informed by the person responsible for your healthcare of possible continuing healthcare requirements following discharge, if any;
  11. refuse to participate in research. Human research affecting care or treatment shall be performed only with your informed consent;
  12. upon request, examine and receive an itemized explanation of your bill, regardless of source of payment;
  13. upon request, review with a practitioner your medical records, as needed, and by paying appropriate charges, receive a copy of your medical record;
  14. know the facility’s rules and regulations that apply to your conduct as a patient;
  15. treatment without discrimination to race, color, religion, sex, national origin, source of payment, political belief, sexual orientation, gender identity, or handicap;
  16. be given the opportunity to participate in decisions involving your healthcare;
  17. be informed of your right to change your primary practitioner if other qualified practitioners are available;
  18. report an incident of abuse, neglect or misappropriation of property, i.e., exploitation, (any consumer, employee, family member, or legal guardian has this right to report) to the NM Department of Health, either independently or through the licensed health care facility , by telephone call, written correspondence or other forms of communication utilizing the DHI Incident Report Form. The Hotline number for the NM Division of Health Improvement (DHI) is 1-800-752-8649.
  19. a process of resolving complaints/grievances relating to the quality of care. When a student/patient complains or has a grievance about the service rendered, and that complaint is not resolved by the employee the person first contacts, the person may see the Assistant to the Director or a Nurse Supervisor, as is appropriate, at the earliest possible time convenient to both. If the person is not satisfied at this level, that person may request a meeting with the Director. If the person with the complaint/grievance is not satisfied with the outcome, after meeting with these individuals, that person may request a meeting with the Vice President of Student Affairs. The VPSA, along with the aggrieved party will determine the time, date and location of the meeting, and if other persons should be present.

Patient Responsibilities

It is the responsibility of the patient:

  1. to provide, as requested, accurate information regarding their identity, health history, and change of health status while undergoing treatment;
  2. to let it be known if they do not comprehend their treatment or what is expected of them in carrying out a plan of care;
  3. to comply with a plan of treatment recommended by the practitioner, and to keep follow-up appointments, or to notify the practitioner when unable to do so;
  4. to accept any consequence of their own actions if they refuse treatment or do not carry out a plan of treatment as recommended by the practitioner;
  5. to see that arrangements are made to take care of their financial expenses for care;
  6. to sign a “Refusal of Treatment” form whenever the practitioner providing the care judges the consequences of refusal of treatment to be substantial;
  7. to conduct oneself in a respectful manner which gives consideration toother patients and Student Health Center personnel. Maintaining a low level of noise, keeping numbers of patient visitors to a minimum, controlling activity of minor children, and no smoking in the building, are expected behavior. The Center does not tolerate abusive behavior by patients, family members or other patient designees. Abusive behavior can result in denial of service and law enforcement intervention.

Patient Forms

Here are some forms available for download that might help speed your next visit to the Campus Health Center. You will be able to fill them out by computer or print them and fill them out by hand.


Patient Health Information Release

Use this link to print the two page Medical History Form which is required to be completed by all patients before their first visit with a health provider at the Campus Health Center. (May also be filed out in person.)

Online Health Resources

Health Information on the WEB

U.S. Department of Health & Human Services:
U.S. Government Flu Website

CDC Vaccine Site:
U.S. Center for Disease Control Website

CDC Emergency Preparedness and Response Site:
The CDC has developed contingency plans for potential public health emergencies and documents them on this site

Disease Information:
General information about medical diagnoses from the Academy of Family Practice.

Disease Information from the NY Times:

Health Screening Recommendations:
U.S. Preventive Services Task Force recommendations for who should receive specific screening tests given their personal situation

Mental Health and Drug Abuse:
Coalition Against Drug Abuse

Mental Health Resource:
U.S. National Library of Medicine, National Institutes of Health mental health information.

Medication Information:
Resource for drug information. This site requires registration, but no payment for basic service.

NIH Medline:
Source of clinical, health, and wellness information from the National Library of Medicine, National Institutes of Health.

Smoking Cessation:
Information and resources from the government on how to quit smoking.

Weight & Obesity Issues:
Government site to help patients with weight control.

Examples of Disclosures

Examples of Disclosures for Treatment, Payment, and Healthcare Operations


Information obtained by a nurse, practitioner, or other member of the CHC healthcare team will be recorded in your record and used to determine the course of your treatment. Members of the healthcare team will record the actions they have taken and their observations.

Communication with Family/Others

We provide practitioner on-call service after hours. In order to safeguard confidentiality, practitioners will ask to speak directly to the patient to disclose protected health information. Only encounters with patients will be recorded in the medical record. Any other types of communication will have to be authorized by you through a medical records release.


A bill may be sent to you, an insurance company, or the person responsible for paying your NMSU account. This may include information that identifies you, your diagnosis, procedures and supplies used. When CHC charges are posted to your NMSU account, the bill will reflect “Campus Health Center” and the amount charged. No health information will be entered on the NMSU bill. This bill will be sent to the person, you have identified, as responsible for paying for your NMSU bill.

Marketing/Information Contact

We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits or services that may be of interest to you. Use of telephone message machines and/or messages left with roommates or other persons who answer the telephone number you disclosed, may be enlisted.

Healthcare Operations

Members of the medical/administrative staff, the risk or quality improvement team may use information in your health record, combined with others like it, to assess care and outcomes. This information will then be used in an effort to continually improve the quality of the healthcare and services we provide.

Business Associates

There are some services provided in our organization through contacts with business associates. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have requested. An example of this would be sending a test to an outside reference laboratory for processing. To protect your health information, we require the business associate to appropriately safeguard your information.

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.


We may use or disclose information to notify you; or notify a family member, personal representative, or another person responsible for your care, in order to obtain your location, as a way to ensure your condition, or to determine if referral care was completed.

Law Enforcement 

We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. We may disclose to law enforcement officials upon request, information for the purpose of identifying or locating a suspect, fugitive, material witness, or missing person or information about an individual who is, or is suspected, to be a victim of a crime.


Your health information may be used by members of appropriate health oversight agencies, public health authorities including the State Department of Health inspection teams in order to determine that professional and clinical standards are followed and the CHC is not endangering patients, workers, or the public.