For Patients
Have a Complaint?
Want to mail in a complaint instead?
You are not required to use this form. You also may write a letter with the same information and send to:
Koble-MN ATTN: Privacy Officer
400 S 4th St. Suite 410 # 46667
Minneapolis, MN 55415-1419
Please do not send any specific medical information such as diagnosis, treatment, or health care payment. This information is being sent to Koble Minnesota via unsecure email.
Note: Instead of contacting the HIPAA Privacy Officer, you can file a written Privacy/Security complaint with the U.S. Department of Health and Human Services (HHS) through the Office of Civil Rights. No retaliation is allowed against the individual filing a complaint. Complaints to HHS must be filed within 180 days of the date you became aware, or should have been aware, of the violation.