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Your Privacy

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Introduction  |  Privacy Forms  |  Privacy Contact Information  |  Privacy Links (links to new page)

Introduction
Kern County Mental Health is committed to protecting the privacy of the persons receiving mental health and/or substance abuse services from our programs. The Health Insurance Portability and Accountability Act of 1996 (HIPAA), the California Welfare and Institutions Code, and other federal, state and local laws govern how providers must protect patient privacy.

In order to meet the requirements within those laws, Kern County Mental Health provides this page of privacy-related documents for your information and use.

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Privacy Forms
Description of Need Form(s)
HIPAA requires us to inform consumers about the rights they have concerning their health information. To view or print a copy of our Privacy Notice, click here. Notice of Privacy Practices
(239K PDF  Updated: 11/12/2009)

Notificación Tocante
a las Prácticas de Privacidad

(250K PDF  Updated: 11/12/2009)

If you want to request a copy of the records created and maintained by Kern County Mental Health, print and complete a: Request to Access or Copy Protected Health Information
(coming soon)
If you wish to limit the use and disclosure of your personal health information, print and complete a: Request for Restriction of Use or Disclosure of Protected Health Information
(51K PDF  Updated: 5/12/2005)
To revoke an authorization, previously granted to this department, print and complete a: Revocation of Authorization for Release of Protected Health Information (151K PDF  Updated: 5/12/2005)
If you want to receive a list of parties who have received your protected health information, without your specific authorization, as allowed by law, print and complete a: Request for Accounting of Disclosures
(50K PDF  Updated: 5/12/2005)
If you believe the records created and maintained by this department are inaccurate or incomplete, you may request an amendment of those records. We may deny this request. To request an amendment, print and complete a: Request for Amendment of Protected Health Information
(52K PDF  Updated: 5/12/2005)
If you believe your privacy has been violated through our policies and procedures, by our staff, or if access, amendment, or restriction requests have been denied and you want to make a complaint, print and complete a: Privacy Complaint Form
(160K PDF  Updated: 5/12/2005)
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Privacy Contact Information
To contact the Kern County Mental Health Privacy Officer:
  CONFIDENTIAL
Privacy Officer
P.O. Box 1000
Bakersfield, CA 93302
888-875-5559
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Last Modified
11/12/2009
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