Notice of Privacy Practices

Your Information and Your Rights

This notice explains common uses of medical information and your rights to see, obtain, and control certain uses of that information. Additional protections may apply under California or other law.

Privacy contact: Fremont Primary Care office, 734 Mowry Avenue, Fremont, CA 94536. Call (510) 742-6274 for instructions on submitting a request. Please do not send medical records through this website.

Access and Correct Your Records

You can ask to inspect or receive an electronic or paper copy of your medical record and other health information held by the practice. Under the HIPAA model, copies are usually provided within 30 days; a reasonable, cost-based fee may apply. Shorter deadlines or additional protections may apply under state law.

You can request a correction if information is inaccurate or incomplete. A request may be denied, but the reason must be provided in writing within the applicable deadline, generally 60 days under HIPAA.

Choose How You Are Contacted

You may request contact at a particular telephone number or mailing address, or by a particular method. Reasonable requests for confidential communication must be accommodated.

Ask for Limits on Sharing

You may ask the practice to restrict certain uses or disclosures for treatment, payment, or health care operations. The practice generally does not have to agree, and emergency treatment may require sharing even when a restriction is agreed to.

If you pay in full out of pocket for a service, you may ask that information about that service not be shared with your health insurer for payment or health care operations. This restriction must generally be honored unless disclosure is required by law.

Other Privacy Rights

• An accounting of disclosures: You can request a list of certain disclosures made during the previous six years. Routine treatment, payment, and operations disclosures and certain other disclosures are excluded. One accounting in a 12-month period is free; a reasonable fee may apply to additional requests.
• A paper notice: You can request a paper copy of the practice’s privacy notice, even if you previously agreed to receive it electronically.
• A representative: Someone with verified legal authority, such as a health care agent or legal guardian, may exercise applicable rights on your behalf.

How Medical Information May Be Used

Medical practices may use and share health information for treatment, to obtain payment, and to operate the practice. For example, information may be shared with another treating clinician or with a health plan to pay a claim.

Other disclosures may be permitted or required by law, subject to the conditions that apply to each situation. These can include public health and safety, reporting suspected abuse or neglect, health research, health oversight, workers’ compensation, organ donation, medical examiners, certain government or law enforcement requests, and legal proceedings.

These are general categories, not permission for unrestricted sharing. Applicable privacy requirements and any stronger legal protections still apply.

Your Choices and Written Permission

You can express preferences about sharing with family, friends, or others involved in your care or payment, and about disaster-relief disclosures. If you cannot communicate a preference, limited information may be shared in your best interest or to lessen a serious and imminent threat.

Written authorization is generally required for marketing, sale of protected health information, and most disclosures of psychotherapy notes. Other uses not covered by the applicable notice or law also require authorization. You can revoke an authorization in writing, except to the extent action has already been taken in reliance on it.

If a practice sends fundraising communications, recipients must be able to opt out. Special advance notice and choice apply when covered substance use disorder records are used for fundraising.

Specially Protected Information

Some information is subject to additional restrictions. To the extent the practice holds substance use disorder patient records covered by 42 CFR Part 2, those records cannot be used or disclosed in investigations or proceedings against a patient without the required written consent or a court order and subpoena.

State or other law may provide stronger protection for certain records. Ask the privacy contact about the protections that apply to your request.

Privacy Responsibilities

A covered medical practice must protect the privacy and security of protected health information, provide its applicable privacy notice, follow the duties described in that notice, and notify affected individuals when a breach requires notification. Revised notices must be made available when practices change.

Questions or Complaints

Contact the office at (510) 742-6274 if you have a privacy concern or need help making a request. You may also file a privacy complaint with the HHS Office for Civil Rights. You must not be retaliated against for making a privacy complaint.

Source: HHS model notice for health care providers, reviewed February 13, 2026. This interim page will be replaced with the practice’s finalized notice.