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Protecting the Privacy of your Health Information
Mendocino Community Health Clinic, Inc. and its staff have a strong commitment to protecting the privacy of your health information.
You have the right to:
- Request a restriction on certain uses and disclosures of your information.
- Obtain a paper copy of our Notice of Health Information Practices upon request.
Click here to download MCHC's notice of privacy practices.
(PDF file size: 291K)
- Inspect and receive a copy of your health record.
- Have your amendment(s) filed into your health record.
- Obtain a listing of who has been given your health information.
- Request confidential communication of your health information by receiving these communications by an alternative means or at an alternative location.
- Revoke in writing your authorization to use or disclose health information except to the extent that action has already been taken.
If you believe your privacy rights have been violated,
you may file a complaint with the MCHC Privacy Officer by phone (below)
or by completing the Privacy Complaint Form.
Once completed, please mail it to:
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| | MCHC Privacy Officer
| | Mendocino Community Health Clinic, Inc.
| | 333 Laws Avenue
| | Ukiah, CA 95482
| | Phone: (707) 472-4633
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