Medical Records laws

Federal, state, and local governments are responsible for protecting and safeguarding the public health and welfare. Accordingly, during terms of various epidemics the state has required the registration of infected persons in order to treat and/or quarantine them and to study the spread of the disease to ultimately control and eradicate it. Thus, although access to medical records is highly guarded, the reporting of diseases is widely practiced at all levels of government. The Center for Disease Control, for example, publishes The Morbidity and Mortality Weekly Report, containing a comprehensive list of all reported illnesses by both state and region that benefits the family practice doctor as well as the epidemiologist. The reports of cases that are reported, from the flu to various venereal diseases to AIDS (acquired immunodeficiency syndrome), are given in confidence, and access to the records is forbidden for most other purposes.

The outbreak of AIDS has sparked controversy over the confidentiality of medical records and diagnoses. Some employers and insurance companies have sought to have individuals tested for the HIV virus, which can lead to AIDS, before hiring in order to prevent considerable expenses in the future as the employee's health fails. Often these same parties argue for access to medical records for background checks as part of the interview process. The great tension regarding the rights of individuals with the HIV virus or AIDS, the public's interest in controlling and fighting the epidemic, and the interest of employers, insurers, and health officials in providing adequate and affordable medical care has created a very dynamic ethical and legal dilemma that will not soon be resolved.

The laws controlling and regulating access to medical records vary greatly from state to state, although the basic protection is always there: a person's medical records are personal and private. As is historically the case, the federal government has gotten increasingly involved in the area of individual rights and has enacted a number of pieces of privacy legislation. For example, the Federal Privacy Act of 1974 requires the release of information in federal files to the subject individual upon request, although some government agencies have established regulations allowing the release of information to a physician chosen by the requesting individual (5 U.S.C. 552a(f)(3)). Federally funded community mental health and mental retardation centers must maintain safeguards to preserve confidentiality and protect the rights of patients (52 U.S.C. 2689(d)(2)), and the Department of Defense may not use for any adverse personnel decision any personal information obtained in interviews with members of the service who are HIV positive (PL 49-661 §705(c)).

This chapter treats all statutes that could be found concerning privacy and medical records. It must be noted, however, that this emerging field is increasingly subject to revision and new legislative attention. In addition, in certain areas such as AIDS information, the courts may have construed other statutes as protecting or not protecting AIDS victims. In these cases the courts may be awaiting or inviting legislative action. Spaces on the chart that are left blank are those situations where specific laws cannot be found; this does not necessarily mean that an individual is without protection in these areas.

Table 35: Medical Records

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
ALABAMA	Notifiable disease records confidential (§22-11A-2)		Tuberculosis, STDs, and notifiable disease cases must be reported to state Board of Health (§22-11A-1 et seq.)	Waiver of medical record of persons infected with sexually transmitted disease by written consent of patient (§22-11A-22)		An individual must be notified of a positive test result including face-to-face counseling, information on health care services and services related to locating and testing persons who have been in contact with infected individual. Otherwise confidentiality must be maintained §22-11A-53 & §22-11A-54
ALASKA	Parent or guardian (§25.20.130); Dept. of Social Services for financial records of medical assistance beneficiaries (§47.07.074); Patient (§18.23.005); Medical Review Organization (§18.23.010 et seq.)	In the case of emergency medical services, records of those treated may be disclosed to EMTs for emergency purposes (§18.08.087)	Physicians must report tuberculosis cases to state medical officer (§18.15.131)	Mental health records may be disclosed only with patient or an individual to whom the patient has given written consent to have information disclosed (§47.30.845(2))

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
ARIZONA	Communicable disease related information confidential; release of information by consent or according to §36-664(A)(1)-(12)	Physicians and surgeons in most cases (§12-2235)	Nonaccidental injuries, malnourishment, physical neglect, sexual abuse, or other deprivation with intent to cause or allow injury or death of minor child must be reported to peace officer or child protective services. Such reports are confidential and may be used only in authorized judicial or administrative proceedings(§13-3620); reports and records about abused or incapacitated adult may only be used in authorized judicial or administrative proceedings (§46-454).			Any release of information must specifically authorize HIV-related information. Person with confidential HIV-related information may not be compelled to disclose information by subpoena, search warrant, or other judicial process, but may report if there is an identifiable third party at risk; no prohibition from listing in death certificate (§36-664)
ARKANSAS	Not open to public (§25-19-105); available to patient (§23-76-129); or through patient's attorney (§16-46-106)	Physician or psychotherapist (Rules Ev. 503)	Physicians must report cases of HIV, Reye's syndrome, and cancer (§20-15-201 et seq.)	Express consent (§23-76-129)		Reporting required to Arkansas Dept. of Health by physicians and other medical and lab directors (§20-15-906); all information and reporting confidential (§20-15-904)

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
CALIFORNIA	May not be disclosed without authorization except for court order, insurance, HMO (Civ. Code §56 et seq.)	Doctors, including psychotherapists and psychiatrists (Ev. §1010); patient must waive doctor-patient confidentiality when plaintiff in civil suit (Ev. §1016)		Patient must waive doctor-patient confidentiality when plaintiff in civil suit (Ev. §1016); other: Civ. Code §56.07	Insurer may obtain to the extent noted in (Civ. Code §56.10(c)(2)) Information disclosed to the extent necessary to allow responsibility for payment to be determined and made	Blood testing must be anonymous and test results may not disclose identities of persons tested even through subpoena (H&S 120975 and 121025)
COLORADO	Patient or designated representative with written authority, except for psychiatric records that would have significant negative psychological impact, in which case patient is entitled to summary (§25-1-801)	Physician, nurse, or psychologist (§13-90-107)	Physicians must report venereal disease, tuberculosis, rabies, and HIV to State Dept. of Public Health (§25-4-401 et seq.)			Confidential counseling and testing preferred; anonymous testing conducted for persons with high risk (§25-4-1405.5)
CONNECTICUT	Patient may see and copy (§4-105); state law limits disclosure of mental health data about a patient by name or other identifier (§52-146h); state departments may receive information on patients only to the extent necessary to obtain support or payment for care of patient; all information is confidential (§17b-225)	Physician (§52-146O)	Physician must report tuberculosis to Dept. of Public Health (§19a-262)			Results confidential except to exposed health care workers, or to mental health or prison facilities (§19a-583)
DELAWARE	All information and records of known or suspected cases of sexually transmitted disease (STD), including HIV infections, shall be strictly confidential; released only under certain circumstances (Tit.16 §711)	Physicians and psychotherapists (R. Ev. 503). Immunity from liability for reporting, in good faith, child abuse (Tit. 16 §908)	Sexually transmitted diseases reported to division of Public Health, some reported in number and manner only (Tit. 16 §702)			Strictly confidential with exceptions made under certain circumstances (Tit. 16 §711)

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
DISTRICT OF COLUMBIA	Medical records generally confidential, but may be transmitted for peer-review or anonymous use in publications (§32-501 et seq.). Public mental health facility must make patient records available to patient's attorney or personal physician upon that person's written authorization (§21-562)	Physician and mental health professionals (§14-307). Does not apply to child abuse reports or in criminal cases involving serious bodily harm (§7-1911)	Mayor may issue list of diseases which physicians must report to Commission of Public Health (§7-131)			Information and records pertaining to persons with AIDS are confidential (§7-1605)
FLORIDA	Patient or his/her legal representative or health care provider except for psychological or psychiatric records which may be provided as a report instead of copies of records (§456.057); patient's guardian, curator, or personal representative, anyone authorized in writing (§395.3025)	Psychotherapist-patient (§456.059)	Physicians must report cases of tuberculosis and STDs to Dept. of Health (§384.25, §392.53)	Medical records not disclosed unless patient gives written authorizations exceptions to the written authorization as provided in (§456.057)		Confidential with exceptions to nondisclosure as provided in §381.004 (3)(e)
GEORGIA	Disclosure of medical records pursuant to laws requiring disclosure or to limited consent to disclosure does not destroy confidential or privileged nature (§24-9-42)	Psychiatrist (§24-9-21); physician (§24-9-40); pharmacist (§24-9-40)	Venereal disease and suspected child abuse (§§19-7-5; 31-17-2)	Patient must make written authorization or waiver (or parents/guardian in case of minor) except by subpoena or appropriate court order (§24-9-40)		All AIDS information confidential (20-9-40.1); may be disclosed to that person or in case of minor to parents or guardian and with notice, to reasonably believed spouse/partner (§24-9-47)
HAWAII	Patient or his attorney, but doctor may require patient's authorization to make them available to attorney if detrimental to patient's health (§622-57)	Physicians and psychologists (R. Ev. 504, 504.1)	Those with diseases or conditions declared to be communicable or dangerous to the public health (§325-2)			All records of AIDS, HIV, or AIDS-related patients are confidential; release of information under circumstances in §325-101

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
IDAHO	Patient or agent by subpoena (§9-420); parent of minor child whether custodial or non (§32-717A); in some civil actions records may be open to discovery (§39-1392e); government medical records exempted from open records law (§9-340C)	Physician (§9-203(4)), psychologist (§9-203(6))	Child abuse cases within 24 hours (§16-1619); enumerated venereal diseases including AIDS and HIV (§39-602)	Patient or doctor or nurse responsible for entries in hospital record may request protective order to deny or limit access (§9-420)		Confidentiality of patient information maintained; use of information restricted to "public health requirements" and "those with a legitimate need to know" (§39-609)
ILLINOIS	Medical records kept strictly confidential (735§5/8-2101)	Physician and psychologist (735§5/8-802)	Child abuse (325 ILCS 5/4); sexually transmissible diseases (410 ILCS §325/4)	Right to privacy and confidentiality in health care may be waived in writing by patient or patient's physician (410§50/3)		AIDS test information must be kept confidential (410 ILCS 305/1, et seq.) No disclosure of AIDS test information without consent, court order or as listed in 410 ILCS 305/9
INDIANA	Patient, authorized representative, authorized health care worker (34-43-1-1, et. seq.; 16-41-8-1, et seq.)	Physicians (34-46-3-1)	Child abuse, HIV, and certain communicable diseases (31-33-5-1, §16-41-2-2)		Insurance company may obtain records with written consent (§16-39-5-2)	All HIV cases must be reported (§16-41-2-3)
IOWA	Medical and psychiatric records held by Dept. of Human Services are confidential and may only be distributed to other agencies in course of official business or researchers so long as identity is not disclosed. (§217.30)	Physicians and mental health practitioners (§622.10)	Confidential reports of venereal disease must be filed (§§139A.30 & .31) Dept. of Public Health may designate other diseases as reportable (§139A.2)			All reports and information related to HIV are strictly confidential medical information; released under circumstance s in 141A.9

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
KANSAS		Doctor-patient (with exceptions) (§60-427); Psychologist-patient (§74-5323)	Any physician or lab director with knowledge of AIDS sufferer must report to secretary of health and environment; information shall be confidential and disclosed as per §65-6002 (c)			Any physician or lab director with knowledge of AIDS sufferer must report to secretary of health and environment; information shall be confidential and disclosed as per §65-6002 (c)
KENTUCKY		Psychiatrist-patient privilege (R. Ev. 507)	Regulations designate diseases which must be reported to Cabinet for Health Services (§214.010)	Patient or physician may ask to prohibit or limit use by protective order (§422.315)		Test results disclosed only to those listed in §214.181
LOUISIANA	Healthcare providers must provide copies of records upon patient's request (unless injurious to health or welfare of patient) or subject to subpoena (§40:1299.96)	Healthcare provider-patient (usually waived in cases of child abuse or molestation) (Code Ev. §510)				Information related to HIV is confidential; disclosure according to §§40:1300.14 and .15
MAINE	Patient unless doctor thinks it would be detrimental to his health, then to an authorized representative (22 §1711); attorney general in a criminal proceeding although still confidential (5 §200-E)	Doctor-patient; psychologist-patient (both abrogated in child protective activity) (22 §4015)	Physicians must report certain communicable diseases (22§822) and malignant tumors (22§1402)			No person may disclose the results of an HIV test with exceptions in 5 §19203

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
MARYLAND	Records of Secretary of Health & Mental Hygiene must be kept confidential. It is unlawful to disclose them except for research (HG §4-101, et seq.)	Psychologist/psychiatrist-patient (C & JP §9-109)	Medical Advisory Board allowed to report to Motor Vehicle Administration on patients whose driving may be impaired for mental or physical reasons (Transp. §16-118) Physicians must report infectious diseases and HIV/AIDS (HG §18-201)			Test results confidential (Health-Gen. §18-334) but if individual refuses to notify sexual or needle-sharing partners physician may inform local health officer (HG §18-337)
MASSACHUSETTS	Patient has right to confidentiality of all records and communications to extent provided by law and to inspect and receive copy of medical records (psychotherapist may give summary of record if it would adversely affect patient's well-being (112 §12CC); mental health records private except for court order, at patient's request, or if mental health commissioner allows for sake of best interest of patient (123 §36)		Any injury from discharge of gun or a burn affecting over 5% of the body or a rape or sexual assault (victim's name not included in report) (112 §12A); physicians may report venereal disease to patient's fiancé or parents (112§12)			Labs and hospitals that conduct blood tests for AIDS must not disclose results without obtaining written informed consent of patients (111 §70F)
MICHIGAN	Any review entity (331.531); Department of Health shall protect privileged communications and individual's expectation of privacy with regard to Department's activities (§333.2611)	Physician-patient (§600.2157)	Serious communicable diseases (§333.5117)			All reports of HIV infection and AIDS are confidential; release subject to §333.5131

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
MINNESOTA	Patient, patient's representative, or minor's parent or guardian has right to copy doctor's and hospital records about themselves (if provider determines that information is detrimental to physical or mental health of patient, may withhold information and supply to third party) (§144.335); mentally committed patients have access (§253B.03)	Physician, nurse, or psychologist may not disclose confidential information acquired in professional capacity without the consent of the patient (§595.02)
MISSISSIPPI	Medical or dental review committee for evaluation of quality of care; patient's identity not divulged (§41-63-1, and 3)	Physician, dentist, nurse, pharmacist and patient (§13-1-21)	Licensing boards may establish reporting requirements for Hepatitis B virus and HIV (§41-34-1, et seq.)	Patient waiver of doctor's privilege implied to comply with state and local health departments and for information regarding communicable diseases (§13-1-21)		Convicted sex offenders shall be tested for HIV; results reported to victims and spouses (§99-19-203)
MISSOURI	Patients or their representatives upon request (§191.227)	Physicians, psychologists chiropractors and dentists (§491.060)				All information concerning one's HIV status is confidential, but may be released to public employees for limited purposes (§191.656)
MONTANA	Patient may authorize disclosure of healthcare information (50-16-526); without patient's authorization, may be released in limited circumstances (50-16-530); all records of Department of Public Health and Human Services are confidential; disclosed according to §41-3-205 (3)	Doctor-patient (§26-1-805); Psychologist-client (§26-1-807)	Must report if conduct is such that might expose another to infection (50-18-106)			Person may not disclose or be compelled to disclose the identity of a subject of an HIV test or results (50-16-1009); HIV testing: 50-16-1007

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
NEBRASKA	Counsel for mentally ill patient (§83-1053); institutional mental health records only accessible to patient, representative, and certain government agencies (§83-1068)	Physicians (§27-504)	Reporting of patients with cancer to Dept. of Health upon its request for Cancer Registry (§81-642); brain injuries for Brain Injury Registry (§81.654); all "reportable diseases" (including sexually transmitted diseases) (§71.503.01)
NEVADA	Patient has right to inspect and copy both doctor's and hospital's records; also authorized representative or investigator (§629.061); Required to forward record upon transfer to new medical facility (do not need patient's consent) (§433.332)	Patient and physician (§49.225)	Communicable diseases (§441A.150)
NEW HAMPSHIRE	Records are deemed property of patient (§332-I:1); anyone with durable power of attorney for health care for patient (§137-J:7); patient and one with his written consent or with written certification of ombudsman (§161-F:14); no employee may be required to bear cost of any medical exam or furnish any records required by employer as condition of employment (§275:3)	Doctor-patient (§329:26)	Communicable diseases (141-C:7)			All records and information pertaining to person's HIV testing are confidential and protected from unwarranted intrusion (141-F:8)
NEW JERSEY	Medical records confidential but may be disclosed to patient, upon court order, and other exceptions (§30:4-24.3)	Psychologist-patient (45:14B-28); Physician-patient (2A:84A-22.1, .2)	Child abuse (§9:6-8.30); pertussis vaccine (§26:2N-5); venereal disease (§26:4-41); AIDS (26:5C-6)			All records with identifying information are confidential (§26:5C-7); disclosure per 26:5C-8, et seq.

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
NEW MEXICO	Office of state long-term care ombudsman for patient/resident/client (§28-17-13); confidential shall not be disclosed without authorization from patient. Authorization not required for disclosure of confidential information in certain circumstance. (§43-1-19); worker, employer, or employer's insurer, or the appropriate peer review organization, all records of any health care service provided the worker, upon written request (§52-10-1)	Physician/psychologist-patient (Rule 11-504)	Sexually transmitted diseases (§24-1-7)			Performance of test and results are confidential; disclosure subject to §24-2B-6
NEW YORK	Medical director of prison in reference to inmate (Corr. §601); ombudsman (Exec §544-a); inspector of a mental facility (Men. Hyg. §16.11); physician or hospital must release medical file to another physician or hospital upon written request of parent, guardian, or patient; records concerning venereal disease treatment or abortion for minor may not be released, even to parent (Pub. Health §17)	Physician, dentist, podiatrist, chiropractor, and nurse. (Civ. Prac. §4504)				All HIV-related information is confidential and may only be disclosed in limited circumstances (Pub. Health §2782)
NORTH CAROLINA	All privileged patient medical records possessed by Department of Health or local health department are confidential (§130A-12); pharmacists when necessary to provide services (§90-85.35)	Physician (§8-53), except in cases of alleged child abuse (§8-53.1)	Physicians, lab directors and local health directors must report communicable diseases; hospitals may report (§130A-134, et seq.)			All AIDS information and records are confidential; subject to release only according to §130A-143
NORTH DAKOTA		Physicians and psychotherapists (Ev. R. 503)	Child abuse and communicable diseases designated by Dept. of Health (§§23-07-01; 50-25.1-01)			Information regarding HIV infection is strictly confidential; release subject to §23-07-02.2)

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
OHIO	Employee or designated representative may request records from employer, physician, health care professional, hospital, or lab when they are contracted by employer (§4113.23)	Doctor-patient (§2317-02(B))	Child abuse (§2151.421); occupational diseases (3701.25); cases of cancer for cancer registry (§3701.262); contagious or infectious diseases (including AIDS) (§3701.24)			Disclosure of HIV or AIDS-related information subject to §3701.243
OKLAHOMA	Patient has access to medical records in the cases of psychological/psychiatric records, patient has access if consented to by treating physician or court orders or upon finding that it is in the best interest of patient (76 §19); health professional may inform parents of treatment needed or provided to minor; such disclosure does not breach right to privacy (63 §2602; 43A §1-109)	Physician/psychotherapist-patient (Tit. 12 §2503)	Child abuse (physical, sexual and/or neglect); communicable or venereal disease (Tit. 10 §7103; Tit. 63 §1-528(b))			HIV tests or records upon written request of person affected, or in cases of certain crimes, test results released to victim (Tit. 63 §1-525)
OREGON	Institutions are encouraged to permit patient to copy doctor and hospital records and prevent unnecessary disclosure (§192.525)		Suspected violence: physical injury with knife, gun or other deadly weapon (in confidence) (§146.750)			HIV test results confidential (§433.075)
PENNSYLVANIA		Physician privilege limited to civil matters (42 §5929)	Communicable diseases (35 §521.4)			All HIV-related information confidential; limited disclosure (35 §7607)
RHODE ISLAND	Patient (§5-37-22); holders of medical records must keep them confidential; patient's written consent generally required (§5-37.3-4)	Health care providers (§9-17-24)	Occupational diseases (§23-5-5); sexually transmitted and communicable diseases (§23-8-1; §23-11-5)			Disclosure of AIDS test result to third parties limited by §23-6-17

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
SOUTH CAROLINA	Patient or representative (§44-115-30)	Mental health provider-patient (19-11-95)	Sexually transmitted diseases (§44-29-70)			Information and records are strictly confidential except in limited circumstances (§44-29-136); in minor cases, if attending public school, superintendent and nurse must be notified; Court orders: (§44-29-135)
SOUTH DAKOTA	Patient or representative (§36-2-16)	Physician and psychotherapist (§19-13-7)	Venereal disease (34-23-2); child abuse or neglect (26-8A-3)		Division of Insurance must keep medical records confidential (§58-4-5)	Victims of sexual assault may request testing and receive notification of results (23A-35B-1, et seq.)
TENNESSEE	Hospital records property of hospital, upon court order or written request of patient may see (§68-11-304); medical records of patients in state facilities and those whose care is paid for by state funds are confidential (§10-7-504)	Psychiatrists (§24-1-207); psychologists (§63-11-213)	Communicable diseases (68-5-101); sexually transmitted diseases (68-10-101)			Law enforcement officer may request arrested person be tested for Hepatitis B or HIV if exposed to blood (68-10-116); records strictly confidential; released as per 68-10-113

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
TEXAS	Medical information identifiable as to individuals is to be kept confidential and information used for studies is privileged (Health & Safety §161.022)	Physician (Occ. §159.002)	Bullet or gunshot wounds (Health & Safety §161.041); certain occupational diseases (Health & Safety §84.003); certain communicable diseases (Health & Safety §81.041)			Public safety workers may require persons tested for HIV if there has been exposure; generally HIV tests are confidential (Health & Safety §81.050, et seq.)
UTAH	Patient's attorney with patient's written authorization (§78-25-25)	Doctor-patient (§78-24-8(4))	Suspected child abuse (§62A-4a-403); communicable and infectious diseases (including HIV and AIDS) (§26-6-3)			All reports regarding communicable diseases are confidential. May only be disclosed to authorized healthcare workers or researchers. (26-6-27)
VERMONT		Physician, chiropractor, dentist, nurse, or mental health professional not allowed to disclose information acquired in attending a patient in a professional capacity (12 §1612)	Infectious venereal diseases (18 §1093)			HIV-related testing and counseling information disclosed upon court order showing "compelling need" that can't be accommodated "by other means" (pseudonym substituted if possible) (12 §1705)

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
VIRGINIA	Subject person can review his/her medical and mental records; however, mental records; however, mental records may not be personally reviewed in physician feels review would be injurious to persons physical or mental health or well-being (§2.2-3705); patient or attorney upon patient's written request to hospital or health care records except for records when doctor declares release would be injurious to patient's health or well-being (§8.01-413)	Duly licensed practitioner of any branch of the healing arts dealing with patient in professional capacity including clinical psychologist (§8.01-399)			Insurance company must provide medical information to individual or to medical professional designated by individual; must notify individual that information was released at time of disclosure (38.2-608)	All test results are confidential, released only to that person, his legal representative, Department of Health, parents of minor, spouse, by court order, and others authorized by law (§32.1-36.1)
WASHINGTON	Patient may authorize disclosure (70.02.030); without authorization: health care providers, penal institution officials, public health authorities (§70.02.050)	Psychologist (18.83.110)	Child abuse or adult dependent or developmentally disabled (§26.44.030); tuberculosis (70.28.010); sexually transmitted diseases (70.24.105)			Disclosure of identity of person investigated, considered, or requested to test for HIV permitted to those under 70.24.105
WEST VIRGINIA	Patient through written request; summary provided in case of psychiatric or psychological treatment (16-29-1)		Sexually transmitted diseases (§16-4-6); suspected child abuse (§49-6A-2); gunshot and other wounds; burns (§§61-2-27 and 27a)			Disclosure of identity of person tested for HIV in limited circumstances (§16-3C-3)

Table 35: Medical Records—Continued

State	Who Has Access	Privilege	Mandatory Reporting	Patient Waiver	Insurance Purposes	AIDS
WISCONSIN	Patient may inspect and copy upon submitting statement of informed consent (§146.83); Patient health care records confidential. May be released to certain persons or to persons with the informed consent of the patient or of a person authorized by the patient. (§146.82)	Physician, registered nurse, chiropractor, psychologist, social worker, marriage and family therapist and professional counselor-patient (§905.04)	Sexually transmitted diseases (§252.11); tuberculosis (§252.07); abused or neglected children and abused unborn children (§48.981); communicable diseases (§252.05)			AIDS/HIV test results must remain confidential except as released per §252.15 (5)
WYOMING	Patient (with written authorization) (§35-2-606); health care providers, family members, researchers (§35-2-609)	Physician (§1-12-101)	Child abuse; sexually transmitted diseases; communicable disease (§§14-3-205; 35-4-130; 35-4-103)