Revised Notice of Privacy Practices (Effective February 16, 2026)
NOTICE OF PRIVACY PRACTICES
[Your Organization Name]
Effective Date: February 16, 2026
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.
We are required by federal law to maintain the privacy of your protected health information (PHI) and to provide you with this Notice of our legal duties and privacy practices. We are also required to abide by the terms of our current Notice.
- How We May Use and Disclose Your Protected Health Information
We may use or disclose your PHI for the following purposes without your written authorization (unless more restrictive laws apply):
- Treatment: To provide, coordinate, or manage your health care (e.g., consulting with other providers).
- Payment: For billing, claims processing, and collections.
- Health Care Operations: For quality assessment, compliance, training, audits, etc.
We may also use or disclose your PHI for other purposes permitted or required by law, such as:
- Public health activities.
- Health oversight activities.
- Judicial/administrative proceedings (with proper safeguards).
- Law enforcement (limited circumstances).
- Abuse/neglect reporting.
- Research (with approvals).
- To avert serious threats to health/safety.
- Workers’ compensation.
- As otherwise required by law.
Special Protections for Substance Use Disorder (SUD) Records Under 42 CFR Part 2
If we create, receive, maintain, or transmit records related to substance use disorder diagnosis, treatment, or referral for treatment from a federally assisted Part 2 program (referred to as “SUD records”), these records have stronger federal protections than standard PHI under HIPAA.
- Many uses and disclosures allowed for other PHI (including for treatment, payment, or health care operations) generally require your written consent under Part 2.
- If you provide written consent for uses/disclosures of SUD records (e.g., a single consent for all future treatment/payment/operations), recipients may further disclose them as permitted under HIPAA without additional consent from you.
- SUD records (or testimony about their content) cannot be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless we have your written consent or a qualifying court order (after you receive notice and an opportunity to be heard), as required by 42 CFR Part 2.
- You have the right to opt out of any fundraising communications that would use your SUD records (if applicable).
- Other permitted uses/disclosures (e.g., medical emergencies, research, audits) follow Part 2 rules, which may be more restrictive than HIPAA.
We will comply with the more stringent requirements when Part 2 applies.
- Your Rights Regarding Your Protected Health Information
You have the right to:
- Request restrictions on certain uses/disclosures (we may not always agree, but if you pay out-of-pocket in full for a service and request restrictions to your health plan, we must agree for that service; similar for SUD records in some cases).
- Receive confidential communications (e.g., alternative mailing address).
- Inspect and obtain a copy of your records (with Part 2 limitations where applicable).
- Request amendments to your records.
- Receive an accounting of certain disclosures (including for SUD records in some instances).
- Receive a paper or electronic copy of this Notice.
- File a complaint if you believe your privacy rights were violated.
- Our Legal Duties
We are required to:
- Maintain the privacy of your PHI and SUD records.
- Provide this Notice and abide by its terms.
- Notify you following a breach of unsecured PHI (and apply breach rules to SUD records).
- Describe any changes to our practices in future Notices.
- Changes to This Notice
We reserve the right to change our privacy practices and this Notice. Changes will apply to all PHI/SUD records we maintain. The current Notice will be posted and available upon request.
- Complaints and Contact Information
If you believe your privacy rights have been violated, contact:
Dr. Daniel R. Pestana/Owner
Phone#: 925-945-8006
Email: [email protected]
Address: 2255 Ygnacio Valley Rd. Ste. J-2,
Walnut Creek, CA 94598
You may also complain to the U.S. Department of Health and Human Services, Office for Civil Rights (details at ocrportal.hhs.gov/ocr/smartscreen/main.jsf).
For more information about this Notice or your rights, contact [Your Contact Info].
This Notice complies with HIPAA (45 CFR § 164.520) and aligns with 42 CFR Part 2 requirements effective February 16, 2026.
For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.