NOTICE OF PRIVACY PRACTICES

This Notice Describes How Medical Information About You May Be Used and Disclosed and How You Can Get Access to This Information. Please Review It Carefully.

Effective Date: 【02/01/2026】

1. OUR RESPONSIBILITIES

We are required by law to maintain the privacy and security of your protected health information (“PHI”). We must follow the duties and privacy practices described in this Notice and give you a copy of it. We are required to notify you promptly if a breach occurs that may have compromised the privacy or security of your information. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time by letting us know in writing.

2. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

We may use and disclose your PHI without your authorization for the following purposes:

Treatment: We may use and share your health information to provide, coordinate, or manage your health care. This includes telehealth visits, documentation, referrals, and communications necessary for your care.
Payment: As a cash-only/self-pay practice, we generally do not bill insurance. However, we may use or disclose information for payment-related activities such as collecting payment directly from you, issuing receipts, or providing superbills if requested.
Health Care Operations: We may use your information for operations such as quality assessment, record keeping, compliance, audits, legal obligations, and administrative activities.
Telehealth Services: Your information may be collected, stored, and transmitted electronically through secure telehealth and electronic health record systems. Despite safeguards, there are inherent risks to electronic communications.
Legal Requirements: We may disclose your PHI when required by federal, California, or Washington law, including public health reporting, audits, investigations, or law enforcement requests.
Public Health & Safety: We may disclose information to prevent or lessen a serious threat to health or safety, or to comply with public health reporting requirements.

3. USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION

We will never use or disclose your PHI for the following purposes without your written authorization:

Marketing purposes
Sale of PHI
Most sharing of psychotherapy notes (if applicable)
Any other use not described in this Notice

4. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the following rights regarding your PHI:

Access Your Records: Request to inspect or obtain a copy of your medical records (usually provided within 30 days).
Request Corrections: Ask us to correct health information you believe is incorrect or incomplete.
Request Confidential Communications: Ask us to contact you in a specific way (e.g., specific email or phone).
Request Restrictions: Ask us not to use or share certain information. If you pay for a service or health care item out-of-pocket in full, and you ask us not to share that information with your health insurer for the purpose of payment or our operations, we must agree to your request.
Receive an Accounting of Disclosures: Request a list (accounting) of the times we’ve shared your health information for up to six years prior to the date of your request.
Receive a Paper Copy: Request a paper copy of this Notice at any time.

5. STATE-SPECIFIC PRIVACY RIGHTS

We comply with the most protective applicable law between Federal (HIPAA), California (CMIA), and Washington (UHCIA) regulations.

California Residents: You have additional protections under the Confidentiality of Medical Information Act (CMIA). You may also have rights under the CCPA/CPRA depending on the nature of the data collected.
Washington Residents: Washington law provides enhanced privacy protections for health data. You have the right to access and protect your data under the Uniform Health Care Information Act (UHCIA) and, where applicable, the My Health My Data Act.

6. CHANGES TO THIS NOTICE

We reserve the right to change this Notice at any time. The new notice will be available upon request, in our office (if applicable), and on our website.

7. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with us or the U.S. Department of Health and Human Services (OCR). We will not retaliate against you for filing a complaint.

8. CONTACT INFORMATION

For any questions regarding this Notice or our privacy practices, please contact:

Privacy Officer: 【Hiroshi Suzuki】
Practice Name: 【Hiroshi Suzuki, MD, PC】
Address: 【2108 N St, #4693, Sacramento, CA 95816】
Email: 【info@hiroshisuzukimdpc.com】
Phone: 【+1-310-853-6692】

Hiroshi Suzuki, MD, PC