Get a copy of your record
You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you. We will explain any lawful limits and may charge a reasonable, cost-based fee.
Privacy practices & patient rights
How we protect and use your health information.
This page describes how medical information about you may be used or shared and how you can access it. Please review it carefully.
Request the clinic’s current formal notice.
This online page is a general patient guide. For the current formal Notice of Privacy Practices, including its effective date and clinic-specific provisions, call (626) 965-8202 or ask for a paper copy at either office.
This online privacy guide is currently available in English. Please call us if you would like language assistance.
01
Your rights
You have rights concerning your health information.
Ask us to correct your record
You may ask us to correct health information you believe is inaccurate or incomplete. We may deny the request in some circumstances, but we will explain the reason in writing.
Request confidential communication
You may ask us to contact you in a particular way, such as at a certain phone number or address. We will accommodate reasonable requests.
Ask us to limit what we use or share
You may request limits on certain uses or disclosures. We are generally not required to agree. If you pay in full out of pocket for an item or service, you may ask us not to share that information with your health plan for payment or operations unless the law requires it.
Get a list of certain disclosures
You may request an accounting of certain disclosures made during the six years before your request. The list does not include every type of disclosure, such as most disclosures for treatment, payment, or health-care operations.
Get a paper copy or use a representative
You may request a paper copy at any time. A person with legal authority to act for you may exercise your privacy rights after we verify that authority.
To exercise a right, call the office and ask for the Privacy Contact. We may ask you to submit a signed written request.
02
Your choices
You can tell us how to handle certain information.
People involved in your care
You may tell us whether to share relevant information with family, friends, caregivers, or others involved in your care or payment for your care. You may also direct choices about disaster-relief situations.
If you cannot tell us your preference—for example, if you are unconscious—we may share information when we believe doing so is in your best interest and is permitted by law.
Written authorization
We will obtain your written authorization when required, including for most uses of psychotherapy notes, marketing, and the sale of health information. You may revoke an authorization in writing, except to the extent we have already relied on it.
Other uses or disclosures not described in the clinic’s current formal notice will be made only with your written authorization when the law requires it.
03
How information may be used or shared
Common purposes permitted by privacy law.
Treat you
We may use and share information with physicians, clinicians, laboratories, pharmacies, specialists, hospitals, and others involved in your care.
Run the practice
We may use and share information to operate the clinic, coordinate services, improve quality, train staff, and contact you about your care.
Bill for services
We may use and share information with health plans or others to confirm coverage, obtain payment, and manage claims.
Other situations allowed or required by law
Subject to applicable conditions, information may also be used or shared for:
- public-health and safety activities, including disease reporting and preventing serious threats;
- health research that meets legal requirements;
- compliance with federal or state law and government health-oversight activities;
- organ and tissue donation, medical examiners, coroners, and funeral directors;
- workers’ compensation, law-enforcement requests, and special government functions; and
- court or administrative proceedings in response to a lawful order, subpoena, or other legal process.
California law may provide additional privacy protections. When laws differ, we will follow the requirements that apply to the information and the circumstances.
Substance-use-disorder records protected by 42 CFR Part 2
To the extent we receive or maintain records protected by 42 CFR Part 2, those records generally may not be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you without your written consent or a court order accompanied by a subpoena or other legal requirement.
04
Our responsibilities
We are responsible for protecting your information.
Privacy and security
We are required by law to protect the privacy and security of protected health information, follow the clinic’s current formal notice, and notify affected individuals if a breach may have compromised the privacy or security of their information.
Changes to the formal notice
The clinic may change its formal Notice of Privacy Practices and make the revised notice apply to information it already has as well as information received in the future. The current notice will be available at both offices, on request, and through this website when approved for online publication.
05
Questions, requests, or complaints
Contact us without fear of retaliation.
Clinic Privacy Contact
Health Alliance Medical Group
17170 Colima Road, Suite GHacienda Heights, CA 91745
Ask for the Privacy Contact when you call or write.
U.S. Department of Health and Human Services
Office for Civil Rights
You may also file a complaint with the HHS Office for Civil Rights online or by mail. Visit the official complaint page for current instructions.
HHS complaint instructions 200 Independence Avenue, S.W.Washington, D.C. 20201
We will not retaliate against you for asking a question, exercising a privacy right, or filing a complaint.
Need help understanding this information?
Call (626) 965-8202 and tell us your preferred language. Interpreter support may be arranged when needed.