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Privacy Rights
You have the right to receive a copy of this Notice of Privacy Practices.
Get More information
You have the right to get more information about our privacy practices. Please contact our Privacy Officer if you have questions.
Look at your records
You, your parents (if you are under 18) or your legal guardian have the right to look at your record. If you wish to see your record, you will be asked to sign a request form. It usually takes about a day to arrange this because a staff person needs to be there while you look at it. They will help find what you want and explain what it says. However, your doctor may ask that you not see some information if s/he thinks that it would be harmful to you. You may have a copy of information created by our agency. If you wish, we will help you get information from other places.
Correct your record
You have the right to correct your record if you think any part is incomplete or wrong. You cannot simply take out any information. You may ask that a statement be added to show what you think is the correct information.
Ask for more restriction of your record
You have the right to ask that we restrict how we use or share your personal information even more. We will consider your request, but we do not have to agree.
Know who received personal information about you
You have the right to know who has received personal information about you, when and why. We keep a record of this whenever we share information with your approval (#2) or without your approval or consent (#3). Ask our Privacy Officer if you want to know who has received information.
Get information in other ways
You have the right to receive information from us in other ways or at other locations. For example, you might want someone to read to you or to use another language. Or, you might need someone to come to your home or meet you at work. We will try to honor any reasonable request. Please make your request in writing to our Privacy Officer.
Make a complaint
You have the right to make a formal complaint to our Privacy Officer. You may want to do this if you think your privacy rights have been violated. Or, you may want to do this if you disagree with a decision we have made about your personal information. A copy of our complaint procedure is attached. We will not retaliate against you for filing a complaint. If you believe your privacy rights have been violated, you also have the right to file a complaint with the Office of Civil Rights of the United States Department of Health and Human Services. The Privacy Officer will provide the address for you.
Privacy Officer
If you want to contact the Privacy Officer, please talk to your Service Coordinator or ask at the reception desk (775-688-1930).