The 学生健康服务 Program maintains a strict confidentiality and privacy 政策以保护您的医疗信息. 有关我们的政策详情，请 please see our 保密声明 and 私隐实务通知 below.

保密声明

Clients have a right to privacy in 学生健康服务. 受保护的健康信息 (PHI) is confidential and is not part of your academic record. 校园里没人知道 a right to see your PHI or have the knowledge that you are receiving treatment without 你的书面许可. There are legal exceptions to our practices in maintaining confidentiality, which can be viewed under our 私隐实务通知. Aside from these exceptions, only 学生健康服务 staff may have access 到您的健康相关信息.

If you have any questions regarding our confidentiality practices, please direct them to the privacy officer/director of 学生健康服务 at 626-585-7244.

私隐实务通知

学生健康服务 is a confidential clinic and the privacy of each client’s protected 健康信息 (PHI) is maintained. 学生健康处除外 服务 staff, and specifically noted exceptions, PHI is not accessible to anyone 没有你的书面许可.

The law allows 学生健康服务 to use or disclose 健康信息 for treatment, payment, health care operations, notification/communication with family (in emergency circumstances), and health oversight activities. 完整解释的纸质副本 可应要求提供).

具体例外情况的解释:

The law allows us to use or disclose your PHI without written 授权 for the 以下用途:

1. 法律规定的:
The law requires us to report abuse, neglect or domestic violence, respond to judicial 或行政诉讼(例如.g. 传票)，或发给执法人员(例如.g. 法庭命令).

2. 治疗:
We may use or disclose 健康信息 about you to provide you with treatment 或服务.  For example, information may be shared with our doctors, nurse practitioners, physician assistants, nurses, health assistants, and other health care personnel to 为你的治疗制定并执行计划.  我们可以，在你的要求和 your permission, share information with providers outside of our system who may be 参与你的治疗.

3. 保健业务:
We may use and disclose 健康信息 about you for health care operations.  For example, we may use your information to review the quality of health services 你收到. This information is anonymized and is for internal review purposes only.

4. 公共卫生:
On occasion, the law requires us to report a client’s 健康信息 to public health authorities for reasons related to: preventing or controlling disease; injury or disability; reporting abuse or neglect; reporting problems with products and reactions to medications to the Food and Drug Administration; and reporting disease or infection 曝光.

5. 工人的补偿:
We may disclose 健康信息 as necessary to comply with worker’s compensation laws. In the case of employees, we report work related injuries to the district business office.

客户的权利

1. 要求特别隐私保护的权利:
   You have the right to request restrictions on certain uses and disclosures of your 健康信息. We reserve the right to accept or reject these requests, and will 通知你我们的决定.
   
   
2. 要求保密通信的权利:
   You have the right to request your 健康信息 in a specific way or at a specific 位置. (You may want us to call and leave messages on your cell phone only.) We will comply with reasonable requests submitted in writing.
   
   
3. 查阅及复制权:
   You have the right to inspect or copy your 健康信息.  学生健康服务 我可以向您收取一般的复印费吗. 你的健康记录在7年后就被销毁了 你最后一次来这里. There may be limited circumstances for which we would deny your request for access, and this decision will be discussed with you at the time of your request.
   
   
4. 修改或补充:
   You have right to amend 健康信息 that you believe to be incorrect or incomplete. 我们保留拒绝你的要求的权利. 应你方要求修改，我们将予以修改 检讨修订程序.
   
   
5. 披露的会计权:
   You have the right to receive an accounting of certain types of disclosures for the 我们得到的PHI.
   
   
6. Right to Paper Copy of 私隐实务通知:

   You have the right to a paper copy of the 私隐实务通知.

7. 选择代理人的权利:
   You have the right to choose someone to act for you, for example by giving them medical 授权书.  A legal guardian or person with medical 授权书 can 对你的健康信息做出选择.  我们会核实这个人是否有权力 在我们采取任何行动之前.
   
   
8. 要求我们共享信息的权利:
   You have the right to ask us to share information with your family, close friends 或者其他照顾你的人. If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is 为了你的最大利益.
   
   
9. 撤销授权的权利:
   There may be other disclosures of your 健康信息 that will require your written 授权.  You generally have the right to revoke an 授权.
   
   

10. 投诉侵犯权利的权利:
    If you feel your rights have been violated, you have the right to file a complaint 与美国.S. Department of Health and Human 服务 Office for Civil Rights, by 给独立大街200号寄了封信., S.W.华盛顿HHH大厦509F室 DC 20101，请致电1-800-368-1019或访问 www.hhs.gov / ocr / / hipaa /投诉/隐私. If you are concerned that 学生健康服务 has violated your privacy rights, or if you disagree with a decision made about access to your records, you also may contact our privacy officer/director (or appointed designee) at 626-585-7244. You 提出投诉不会受到处罚吗.

Download Authorization to Release Health Information Form