Your Information.

Your Rights.

Our Responsibilities.


This page describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

You have the right to:

  • Get a copy of your paper or electronic medical record.
  • Correct your paper or electronic medical record.
  • Request confidential communication.
  • Ask us to limit the information we share.
  • Get a list of those with whom we’ve shared your information.
  • Get a copy of this privacy notice.
  • Choose someone to act for you.
  • File a complaint if you believe your privacy rights have been violated.

When it comes to your health information, you have certain rights.

This section explains your rights and some of our responsibilities to help you.


You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.

We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

You can ask us to correct health information about you that you think is incorrect or incomplete.  Ask us how to do this.

We may say “no” to your request, but we’ll tell you why in writing within 60 days.

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.

We will say “yes” to all reasonable requests.

You can ask us not to use or share certain health information for treatment, payment, or our operations.  We are not required to agree to your request, and we may say “no” if it would affect your care.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.  We will say “yes” unless a law requires us to share that information.

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.

We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).

We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.  We will provide you with a paper copy promptly.

If you have given someone medical power of attorney of if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

We will make sure the person has this authority and can act for you before we take any action.

You can complain if you feel we have violated your rights by contacting us using the information above.

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to:

200 Independence Ave, S.W., Washington, D.C. 20201. You may also call 1-877-696-6775, or visit this website. We will not retaliate against you for filing a complaint.


You have some choices in the way that we use and share information as we:

  • Tell family and friends about your condition.
  • Provide disaster relief.
  • Include you in a hospital directory.
  • Provide mental health care.
  • Market our services and sell your information.
  • Raise funds.

For certain health information, you can tell us your choices about what we share.

If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.


In these cases, you have both the right and choice to tell us to:

Share information with your family, close friends, or others involved in your care.

Share information in a disaster relief situation.

Include your information in a hospital directory.

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest.

We may also share your information when needed to lessen a serious and imminent threat to health and safety.


In these cases we never share your information unless you give us written permission:

Marketing purposes

Sale of your information

Most sharing of psychotherapy notes.


In the case of fundraising:

We may contact you for fundraising effores, but you can tell us not to contact you again.


We may use and share your information as we:

  • Treat you.
  • Run our organization.

  • Bill for your services.

  • Help with public health and safety issues.
  • Do research.
  • Comply with the law.
  • Respond to organ and tissue donation requests.
  • Work with a medical examiner or funeral director.
  • Address workers’ compensation, law enforcement, and other government requests.

  • Respond to lawsuits and legal actions.


How do we typically use or share your health information?

We typically use or share your health information the following ways.


We can use your health information and share with other professionals who are treating you.

Example: a doctor treating you for an injury asks another doctor about your overall health condition.

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services.

We can share health information about you for certain situations such as, Preventing disease, helping with product recalls, reporting adverse reactions to medications.

Also, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.

We can use or share your information for health research.

We will share information about you if state or federal laws require it.

We will share information with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

We can share health information about you with organ procurement organizations.

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

We can use or share health information about you for workers compensation claims, law enforcement purposes or with a law enforcement official.

We can use or share health information about you with health oversight agencies for activities authorized by law and for special government functions such as military, national security, and presidential protective services.

We can share information about you in response to a court or administrative order, or in response to a subpoena.


How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information visit the Health and Human services website by clicking here.


Our Responsibilities:

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

  • We must follow the duties and privacy practices described in this notice and give you a copy of it.

  • We will not use or share your information other than as described here unless you tell us we can in writing.  If you tell us we can, you may change your mind at any time.  Let us know in writing if you change your mind.
  • We can change the terms of this notice, and the changes will apply to all information we have about you.  The new notice will be available upon request, in our office, and on our website.
  • For more information visit the health and human services website here.

Disclosures & Exceptions

Exception for Drug & Alcohol Services: Disclosure of information to other providers requires that a release of confidential information be completed for each provider.

Exception for Mental Health Services: In general, information in mental health records may not be released unless you or another person with legal capacity has consented to the release or unless there is a court order for the release or unless there is a specific law requiring the release.

Information given in confidence by a member of a patient’s family to a physician, licensed psychologist, social worker with a master’s degree in social work, licensed marriage and family therapist, nurse, or attorney may not be released even by consent of the client.

Mental health information may be released to law enforcement only:

  • As needed for the protection of federal and state elective constitutional officer and their families. (Applies to releasing information to government law enforcement agencies.)
  • When the patient, in the opinion of their psychotherapist, presents a serious danger of violence to a reasonably foreseeable victim or victims; or
  • When a law enforcement officer presents an arrest warrant to a state hospital, a general acute care hospital, an acute psychiatric hospital, a psychiatric health facility, a mental health rehabilitation center, or a skilled nursing facility, the law enforcement officer may be informed whether or not the individual name on the arrest warrant is presently confined in the facility. in this instance, the officer may enter the facility to arrest the individual name on the warrant.

This Notice of Privacy Practices applies to the following organizations.

This notice applies to all Tehama County Health Services (TCHSA) centers. For a full list of centers and programs please visit our website.

Effective Date: 10/01/20

Connections