Randi Compton

Oversaw family dynamics and household management since 2006. Cultivated a nurturing environment for children, fostering their growth and independence. Ready to leverage skills and experiences gained during this period into a professional setting.

Oversaw participation in travel league sports, primarily volleyball, while managing time effectively. Cultivated strong teamwork and leadership skills through engagement in competitive sports. Fostered a passion for sports and commitment to team success.

Managed enrollment at Ivy Tech Muncie Campus, focusing on psychology. Temporarily paused academic pursuits for personal reasons. Actively seeking veterinary technician certification to contribute to animal care. Cultivated a lifelong passion for animals in a pet-friendly environment.

Fostered a positive environment by guiding individuals in overcoming challenges. Cultivated creativity through collaboration with diverse groups. Demonstrated a strong commitment to hair and makeup, initiating practice at age 13 and mentoring others.

Developed a strategic plan to maximize achievements and reach desired objectives.

• Adams Memorial Hospital, 1100 Mercer Ave., P.O. Box 151, Decatur, IN 46733 (260) 724-2145
• Patient Information
• Patient Name: ___________________________ D.O.B. ___________________________
• Medical Record Number: __________________ Address: ___________________________
• Phone Number: (H) __________________ (W) __________________
• I request access to the following medical record:
• Date of Service: __________________ Type of Service: __________________
• I understand that the department will act on a request for access no later than 30 days after receipt of the request as follows: if the request for access is for PHI that is not maintained or accessible to the department on-site, the department must take action on the request for access no later than 60 days from the receipt of such a request, provided that the department notifies the patient with a written statement of the reasons for the delay and the date by which the department will complete its action.
• I understand a cost may be incurred for this request. This fee is due upon receipt of the medical information.
• Signature (patient) ___________________________ Date ___________________________
• Signature (if other than patient: personal representative, guardian, parent) ___________________________ Date ___________________________
• Relationship to patient ___________________________
• For Healthcare Organization Use Only
• Granted-Access ___ Denied-Reviewable ___ Denied - Nonreviewable
• If denied, complete the Denial of Access (form 5) and forward the Request for Access (form 1) and the Denial of Access (form 5) to the HIS Dept. staff for processing.
• Department ___________________________ Associate Name ___________________________ Date ___________________________
• Health Information Services Staff Use Only
• Reviewable Denial Letter sent. Associate Name: ___________________________ Date: ___________________________
• Nonreviewable Denial Letter sent. Associate Name: ___________________________ Date: ___________________________
• Review Letter sent. Associate Name: ___________________________ Date: ___________________________
• Review Process
• Denial-Upheld ___ Denial-Reversed ___ Comments: ___________________________
• Reviewed by: Signature: ___________________________ Print Name: ___________________________
• Title: ___________________________ Date: ___________________________
• O/HIPAA policies/access form 1—request for access—patient pick-up AMH rev. 7/21/16