Student Health Services HIPAA Statement

This notice describes how medical information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully.

Uses and Disclosures

The Student Health Center (SHC) uses health information about you for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive. Continuity of care is part of treatment and your records may be shared with other providers to whom you are referred. We may use or disclose identifiable health information about you without your authorization in several situations, but beyond those situations, we will ask for written authorization before using or disclosing any identifiable health information about you.

Your Rights

In most cases, you have the right to look at or obtain a copy of your health information. If you request copies, we will charge only normal photocopy fees. You also have the right to receive a list of certain types of disclosures of your information that we have made. If you believe that information in your record is incorrect, you have the right to request that it be amended.

Our Legal Duty

We are required by law to protect the privacy of your information, provide this notice about our information practices, follow the information practices that are described in this notice, and seek your acknowledgment of receipt of this notice. Before we make a significant change in our policies, we will change our notice and post the new notice in the waiting area. You can also request a copy of our notice at any time. For more information about our privacy practices, contact the person listed below.

Complaints

If you believe your privacy rights have been violated, or you disagree with a decision we made about access to your records, you may contact the person listed below or file a complaint with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. The person indicated below can provide you with the appropriate address upon request. If you have any questions or complaints,

please contact:
MIA N. ROBERTSHAW
Interim Assistant Superintendent/Vice President of Student Learning and Success
College of Marin
835 College Avenue
Kentfield, CA 94904
(415) 485-9618