1. Right to Request Special Privacy Protections. You have the right to request
restrictions on certain uses and disclosures of your health information, by a
written request specifying what information you want to limit and what limitations
on our use or disclosure of that information you wish to have imposed. We reserve
the right to accept or reject your request, and will notify you of our decision.
2. Right to Request Confidential Communications. You have
the right to request that you receive your health information in a specific way
or at a specific location. For example, you may ask that we send information to
a particular e-mail account or to your work address. We will comply with all reasonable
requests submitted in writing which specify how or where you wish to receive these
communications. 3. Right to Inspect and Copy. You have the
right to inspect and copy your health information, with limited exceptions. To
access your medical information, you must submit a written request detailing what
information you want access to and whether you want to inspect it or get a copy
of it. We will charge a reasonable fee, as allowed by California law. We may deny
your request under limited circumstances. If we deny your request to access your
child's records because we believe allowing access would be reasonably likely
to cause substantial harm to your child, you will have a right to appeal our decision.
If we deny your request to access your psychotherapy notes, you will have the
right to have them transferred to another mental health professional. 4.
Right to Amend or Supplement. You have a right to request that we amend your health
information that you believe is incorrect or incomplete. You must make a request
to amend in writing, and include the reasons you believe the information is inaccurate
or incomplete. We are not required to change your health information, and will
provide you with information about this medical practice's denial and how you
can disagree with the denial. We may deny your request if we do not have the information,
if we did not create the information (unless the person or entity that created
the information is no longer available to make the amendment), if you would not
be permitted to inspect or copy the information at issue, or if the information
is accurate and complete as is. You also have the right to request that we add
to your record a statement of up to 250 words concerning any statement or item
you believe to be incomplete or incorrect. 5. Right to an
Accounting of Disclosures. You have a right to receive an accounting of disclosures
of your health information made by this medical practice, except that this medical
practice does not have to account for the disclosures provided to you or pursuant
to your written authorization, or as described in paragraphs 1 (treatment), 2
(payment), 3 (health care operations), 6 (notification and communication with
family) and 16 (specialized government functions) of Section A of this Notice
of Privacy Practices or disclosures for purposes of research or public health
which exclude direct patient identifiers, or which are incident to a use or disclosure
otherwise permitted or authorized by law, or the disclosures to a health oversight
agency or law enforcement official to the extent this medical practice has received
notice from that agency or official that providing this accounting would be reasonably
likely to impede their activities. 6. You have a right to
a paper copy of this Notice of Privacy Practices, even if you have previously
requested its receipt by e-mail. If you would like to have a more detailed explanation
of these rights or if you would like to exercise one or more of these rights,
contact our Privacy Officer listed at the top of this Notice of Privacy Practices.
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