Notice of Privacy Practices

Last updated: Draft — pending review

Note for the practice: HIPAA requires a complete, practice-specific Notice of Privacy Practices. This is a placeholder outline only. Please replace it with your finalized notice, reviewed by a qualified healthcare attorney, before launch.

Our commitment to your privacy

We are committed to protecting the privacy of your protected health information (PHI). This notice describes how medical information about you may be used and disclosed, and how you can get access to this information.

How we may use and disclose your health information

• Treatment: to provide, coordinate, or manage your mental health care.
• Payment: to bill and obtain payment for services from you or your insurer.
• Health care operations: for activities necessary to run the practice and ensure quality care.
• As required by law: including certain safety situations where disclosure is permitted or required.

Your rights regarding your health information

• The right to inspect and request a copy of your records.
• The right to request a correction to your records.
• The right to request confidential communications.
• The right to request restrictions on certain uses and disclosures.
• The right to an accounting of certain disclosures.
• The right to a paper copy of this notice.

Questions or complaints

If you have questions about this notice or believe your privacy rights have been violated, contact us at info@ujinnerpeacehealthcareservices.com or (805) 876-4522. You will not be penalized for filing a complaint.