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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/
(Aviso sobre las normas de privacidad) send a request by mail to the address listed below, OR
Click here to download the ENGLISH VERSION of this document.
Chasque aquí para descargar la VERSIÓN DE LA ESPAÑOL de este documento.
- 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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To view an earlier version of MCHC's Notice of Privacy Policy/Aviso sobre las normas de privacidad, (version prior to 2008), please click here.
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