HEALTH INFORMATION THAT WE MAINTAIN ABOUT YOU

We maintain records of:

• your name and (if different) the name and relationship of the person receiving care, your address, and your telephone number

• your (or the patient’s, if different) condition that brings you to Pregnancy Care Center

• clinical findings related to your condition, such as pregnancy tests, limited OB ultrasound

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the right to:

• restrictions on certain uses and disclosures

• receive communications of protected health information by alternative means or at alternative 
  locations (e.g., different phone number or email address)

•   inspect, copy, and request an amendment to your protected health information held at  Pregnancy Care Center
  Requesting copies: We will provide a copy or a summary of your health information, usually within 
  30 days of your request, and may include a reasonable fee.
  Correction to medical record: We may say ‘no’ to your request, but we will tell you why in writing 
  within 60 days of your request.

• receive an accounting of certain disclosures (of your protected health information)

• receive a paper copy of this notice even if you have received it electronically

• choose someone to act on your behalf (medical power of attorney/legal guardian)

HOW WE USE AND DISCLOSE YOUR HEALTH INFORMATION

We only use or disclose your health information as state and federal laws require or permit. In some cases, the law requires that you authorize the disclosure. In other cases, the law allows us to disclose your health information without your authorization.

Use and Disclosure Not Requiring Your Authorization

• Treatment: We may use your health information for treatment activities, such as disclosing it to other healthcare providers as needed to provide treatment for you.

• Healthcare Operations: We may use and disclose your health information to manage our program operations, such as reviewing the quality of services you receive.

• To Contact You: We may use the information in your health records to contact you if we have health related
  questions or concerns.

Permitted Disclosures of Personal Health Information (PHI)

Our Privacy Practices and Rights allow for the use or disclosure of your personal health information (PHI)
for certain purposes without your consent or authorization, as permitted or required by law. While such
disclosures are rare in our experience—and the limited information we maintain is generally not
applicable—we are committed to transparency regarding how your information may be handled.

When authorized by law, and to the extent that we possess the relevant information, we may disclose it
for the following purposes:

• comply with the requirements of federal, state, or local laws, court orders, or other lawful process and for administrative or court proceedings

• report to a public health authority for the purpose of preventing or controlling disease, injury, or disability

• report to the FDA for the quality, safety, or effectiveness of FDA-regulated products or activities

• report abuse, neglect, or domestic violence to a government authority

• provide necessary information to a health oversight agency for activities such as audits, investigations, inspections, licensure of the healthcare system, government benefit programs, and regulated entities

• a law enforcement official for specified law enforcement purposes

• prevent or lessen a serious and imminent threat to the health and safety of a person or the public

• authorized federal officials for specialized government functions such as military and veterans activities; national security and intelligence activities; protective services for the president; medical suitability determinations; correctional institutions; government entities providing public benefits

• comply with workers’ compensation laws

 

Uses and Disclosures with Your Authorization

Other uses and disclosures of your personal information require your written authorization. You may revoke your authorization at any time by doing so in writing.

 

HOW YOU CAN REACH US

If you want additional information about our privacy practices or if you believe Pregnancy Care Center

has violated your privacy rights, you may file a complaint by contacting:

 

Pregnancy Care Center

1127 E. Olive Ave.

Fresno, CA 93728

​

 

Additional Protections for Certain Information

• Confidential HIV Related Information for which additional protections are provided by state law

• Alcohol or Substance Abuse Treatment Information for which additional protections are provided by state law

• Mental Health Treatment Information for which additional protections are provided by state law.