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Planned Parenthood Hudson Peconic is dedicated to ensuring all patients receive high-quality service and have a seamless experience at our health centers. See below for patient forms and information. 

Patient Rights and Privacy 

Request for Medical Records 

To transfer your health records from PPHP to another health facility, please fill out this form. 

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HIPAA Privacy Policy 

Read PPHP's HIPPA Privacy Policy to learn about our privacy practices concerning health information about our patients. 

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Notice of Health Information Privacy Practices 

Learn more about how PPHP protects health information about you and circumstance when we may disclose health information.

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Care Everywhere Authorizations and Statuses

Care Everywhere is an electronic record sharing application that allows Planned Parenthood to share and receive your records at the point of care to help make your visit more efficient. 

Learn more about different levels of authorization available. 

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Heathy Care Proxy 

The New York Health Care Proxy Law allows you to appoint someone you trust — for example, a family member or close friend – to make health care decisions for you if you lose the ability to make decisions yourself.

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Telehealth Services Patients' Bill of Rights 

As a patient receiving telehealth services in a clinic in New York State, you have rights. 

Learn More (EN and ES)

Payment Information

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

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Family Planning Benefit Program

You may be eligible to get free birth control, STI testing, exams, and more through New York State’s Family Planning Benefit Program (FPBP).

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Find out more about which insurance plans we accept at PPHP. 

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Need an appointment?

  • See our locations and hours

  • Learn about our services 

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