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.

We understand the importance of privacy and are committed to maintaining the confidentiality of your medical information. We make a record of the medical care we provide and may receive such records from others. We use these records to provide or enable other health care providers to provide quality medical care, to obtain payment for services provided to you as allowed by your health plan, and to enable us to meet our professional and legal obligations to operate this medical practice properly.

We are required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information.

This Notice describes how we may use and disclose your medical information. It also describes your rights and our legal obligations with respect to your medical information.

If you have any questions about this Notice, please contact our Privacy Officer or Dr. Sameer Hassamal.

A. How This Medical Practice May Use or Disclose Health Information

This medical practice collects medical and related identifiable patient information, such as billing information, claims information, referral information, and health plan information, and stores it in a chart, in administrative or billing files, and on a computer.

The medical record is the property of this medical practice, but the information in the medical record is accessible to the patient.

This information is considered Protected Health Information (PHI) under the HIPAA Privacy Rule.

The law permits us to use or disclose health information for the following purposes without the patient's written authorization:

1. Treatment

We use medical information to provide medical care. We disclose medical information to our employees and others who are involved in providing the care our patients need.

For example, we may share medical information with other physicians or other health care providers who will provide services that we do not provide, or we may share this information with a pharmacist who needs it to dispense a prescription or a laboratory that performs a test.

We may also disclose medical information to members of a patient's family or others who can help them when they are sick or injured, or following the patient's death.

2. Payment

We use and disclose PHI to obtain payment for the services we provide.

For example, we give health plans the information they require for payment. We may also disclose information to other health care providers to assist them in obtaining payment for services they have provided to our patients.

3. Health Care Operations

We may use and disclose PHI to operate this medical practice.

For example, we may use and disclose this information to review and improve the quality of care we provide or the competence and qualifications of our professional staff.

We may use and disclose this information to obtain health plan authorization for services or referrals.

We may also use and disclose this information as necessary for medical reviews, legal services, audits, including fraud and abuse detection and compliance programs, and business planning and management.

We may also share PHI with our business associates, such as our billing service, that perform administrative services for us.

We have a written contract with each of these business associates that contains terms requiring them and their subcontractors to protect the confidentiality and security of this PHI.

Although federal law does not protect health information that is disclosed to someone other than another health care provider, health plan, health care clearinghouse, or one of their business associates, California law prohibits recipients of health care information from further disclosing it except as specifically required or permitted by law.

a. We may also share PHI with other health care providers, health care clearinghouses, or health plans that have a relationship with our patients when they request this information to help them with their quality assessment and improvement activities, patient-safety activities, population-based efforts to improve health or reduce health care costs, protocol development, case management or care coordination activities, review of competence, qualifications and performance of health care professionals, training programs, accreditation, certification or licensing activities, activities related to contracts of health insurance or health benefits, or health care fraud and abuse detection and compliance efforts.

b. We may also share PHI with other health care providers, health care clearinghouses, and health plans that participate with us in organized health care arrangements (OHCAs) and health care operations. OHCAs include hospitals, physician organizations, health plans, and other entities that collectively provide health care services.

4. Appointment Reminders

We may use and disclose medical information to contact and remind our patients about appointments.

If the patient is not home, we may leave this information on the patient's answering machine or in a message left with the person answering the phone.

4A. Text Message Appointment Reminders and Mobile Information Privacy

The California Neuropsychiatric Institute may use patients' mobile telephone numbers to send SMS/text message appointment reminders and other communications related to appointments and patient care.

Participation in text messaging is voluntary.

No mobile information will be shared with third parties or affiliates for marketing or promotional purposes.

Information sharing with subcontractors or service providers in support of services, such as appointment reminders, communications technology, and customer service, is permitted as necessary to provide those services.

Text messaging originator opt-in data and consent will not be shared with any third parties, excluding aggregators and providers of the Text Message services.

Patients may opt out of receiving text message communications in accordance with the opt-out instructions provided in the text messages or by contacting our office.

Opting out of text message communications will not affect a patient's ability to receive care from The California Neuropsychiatric Institute.

5. Sign-In Sheet

We may use and disclose medical information about our patients by having them sign in when they arrive at our office.

We may also call out their names when we are ready to see them.

6. Notification and Communication with Family

We may disclose our patient's health information to notify or assist in notifying a family member, personal representative, or another person responsible for their care about their location or general condition or, in the event of their death, unless a patient has instructed us otherwise.

In the event of a disaster, we may disclose information to a relief organization so that they may coordinate these notification efforts.

We may also disclose information to someone who is involved with our patient's care or helps pay for care.

If our patient is able and available to agree or object, we will give the patient the opportunity to object prior to making these disclosures, although we may disclose this information in a disaster even over the patient's objection if we believe it is necessary to respond to the emergency circumstances.

If our patient is unable or unavailable to agree or object, our health professionals will use their best judgment in communicating with the patient's family and others.

7. Marketing

Provided we do not receive any payment for making these communications, we may contact our patients to encourage them to purchase or use products or services related to their treatment, case management or care coordination, or to direct or recommend other treatments, therapies, health care providers or settings of care that may be of interest to them.

We may similarly describe products or services provided by this practice and tell our patients which health plans we participate in.

We may receive financial compensation to talk with our patients face-to-face, to provide them with small promotional gifts, or to cover our cost of reminding them to take and refill medication or otherwise communicate about a drug or biologic that is currently prescribed for the patient, but only if the patient either:

1. Has a chronic and seriously debilitating or life-threatening condition and the communication is made to educate or advise the patient about treatment options and otherwise maintain adherence to a prescribed course of treatment; or

1. Is a current health plan enrollee and the communication is limited to the availability of more cost-effective pharmaceuticals.

If we make these communications while the patient has a chronic and seriously debilitating or life-threatening condition, we will provide notice of the following in at least 14-point type:

1. The fact and source of the remuneration; and

1. The patient's right to opt out of future remunerated communications by calling the toll-free number.

We will not otherwise use or disclose PHI for marketing purposes or accept payment for other marketing communications without the patient's prior written authorization.

The authorization will disclose whether we receive any financial compensation for any marketing activity our patients authorize, and we will stop future marketing activity to the extent the patient revokes that authorization.

8. Sale of Health Information

We will not sell our patient's health information without their prior written authorization.

The authorization will disclose that we will receive compensation for PHI if the patient authorizes us to sell it, and we will stop future sales of information to the extent that the patient revokes that authorization.

9. Required by Law

As required by law, we will use and disclose our patient's health information, but we will limit our use or disclosure to the relevant requirements of the law.

When the law requires us to report abuse, neglect, or domestic violence, respond to judicial or administrative proceedings, or respond to law enforcement officials, we will further comply with the requirements concerning those activities.

10. Public Health

We may, and are sometimes required by law, to disclose our patient's health information to public health authorities for purposes related to preventing or controlling disease, injury, or disability; reporting child, elder or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.

When we report suspected elder or dependent adult abuse or domestic violence, we will inform our patients or their personal representative promptly unless, in our best professional judgment, we believe the notification would place a patient at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.

11. Health Oversight Activities

We may, and are sometimes required by law, to disclose our patient's health information to health oversight agencies during audits, investigations, inspections, licensure, and other proceedings, subject to the limitations imposed by federal and California law.

12. Judicial and Administrative Proceedings

We may, and are sometimes required by law, to disclose our patient's health information during any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order.

We may also disclose information about our patients in response to a subpoena, discovery request, or other lawful process if reasonable efforts have been made to notify them of the request and they have not objected, or if their objections have been resolved by a court or administrative order.

13. Law Enforcement

We may, and are sometimes required by law, to disclose our patient's health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness, or missing person; complying with a court order, warrant, grand jury subpoena; and other law enforcement purposes.

14. Coroners

We may, and are often required by law, to disclose our patient's health information to coroners in connection with their investigations of deaths.

15. Organ or Tissue Donation

We may disclose our patient's health information to organizations involved in procuring, banking, or transplanting organs and tissues.

16. Public Safety

We may, and are sometimes required by law, to disclose our patient's health information to appropriate persons to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the public.

17. Proof of Immunization

We will disclose proof of immunization to a school where the law requires the school to have such information prior to admitting a student if the patient has agreed to the disclosure on behalf of themselves or their dependent.

18. Specialized Government Functions

We may disclose our patient's health information for military or national security purposes or to correctional institutions or law enforcement officers that have the patient in their lawful custody.

19. Workers' Compensation

We may disclose our patient's health information as necessary to comply with workers' compensation laws.

For example, to the extent our patient's care is covered by workers' compensation, we will make periodic reports to their employer about their conditions.

We are also required by law to report cases of occupational injury or occupational illness to the employer or workers' compensation insurer.

20. Change of Ownership

If this medical practice is sold or merged with another organization, our patient's health information and records will become the property of the new owner, although our patients will maintain the right to request that copies of their health information be transferred to another physician or medical group.

21. Breach Notification

In the case of a breach of unsecured protected health information, we will notify our patients as required by law.

If they have provided us with a current email address, we may use email to communicate information related to the breach.

In some circumstances our business associate may provide the notification.

We may also provide notification by other methods as appropriate.

22. Other Disclosures Specified in Our Notice of Privacy Practices

We may disclose our patient's health information as otherwise described in our Notice of Privacy Practices.

23. Psychotherapy Notes

We will not use or disclose our patient's psychotherapy notes without their prior written authorization except for the following:

1. Treatment;

1. Training our staff, students, and other trainees;

1. To defend ourselves if the patient sues us or brings another legal proceeding;

1. If the law requires us to disclose the information to the patient or the Secretary of HHS or for another reason;

1. In response to health oversight activities concerning the patient's psychotherapist;

1. To avert a serious threat to health or safety; or

1. To the coroner or medical examiner following the patient's death.

To the extent the patient revokes an authorization to use or disclose their psychotherapy notes, we will stop using or disclosing these notes.

24. Research

We may disclose our patient's health information to researchers conducting research with respect to which their written authorization is not required, as approved by an Institutional Review Board or privacy board, in compliance with governing law.

25. Fundraising

We may use or disclose our patient's demographic information, the dates that they received treatment, the department of service, their treating physician, outcome information, and health insurance status to contact them for our fundraising activities.

If they do not want to receive these materials, the patient may notify the Privacy Officer, and we will stop further fundraising communications.

Similarly, the patient should notify the Privacy Officer if they decide they want to start receiving these solicitations again.

B. When This Medical Practice May Not Use or Disclose Health Information

Except as described in this Notice of Privacy Practices, this medical practice will, consistent with its legal obligations, not use or disclose health information that identifies individual patients without their written authorization.

If a patient authorizes this medical practice to use or disclose health information for another purpose, the patient may revoke the authorization in writing at any time.

C. Our Patients' Health Information Rights

1. Right to Request Special Privacy Protections

Our patients have the right to request restrictions on certain uses and disclosures of their health information by a written request specifying what information they want to limit and what limitations on our use or disclosure of that information they wish to have imposed.

If our patients tell us not to disclose information to their commercial health plan concerning health care items or services for which they paid in full out-of-pocket, we will abide by their request unless we must disclose the information for treatment or legal reasons.

We reserve the right to accept or reject any other request and will notify our patients of our decision.

2. Right to Request Confidential Communications

Our patients have the right to request that they receive their health information in a specific way or at a specific location.

For example, they may ask that we send information to a particular email account or to their work address.

We will comply with all reasonable requests submitted in writing that specify how or where our patients wish to receive these communications.

3. Right to Inspect and Copy

Our patients have the right to inspect and copy their health information, with limited exceptions.

To access their medical information, our patients must submit a written request detailing what information they want access to, whether they want to inspect it or obtain a copy, and, if they want a copy, their preferred form and format.

We will provide copies in the requested form and format if it is readily producible, or we will provide our patients with an alternative format they find acceptable.

If we cannot agree and we maintain the record in an electronic format, we will provide their choice of a readable electronic or hard-copy format.

We will also send a copy to any other person our patients designate in writing.

We will charge a reasonable fee that covers our costs for labor, supplies, postage, and, if requested and agreed to in advance, the cost of preparing an explanation or summary, as allowed by federal and California law.

We may deny our patient's request under limited circumstances.

If we deny a request to access a child's records or the records of an incapacitated adult because we believe allowing access would be reasonably likely to cause substantial harm to the patient, the guardian or legal representative will have a right to appeal our decision.

If we deny a patient's request to access their psychotherapy notes, our patients will have the right to have them transferred to another mental health professional as permitted by law.

4. Right to Amend or Supplement

Our patients have a right to request that we amend their health information if they believe it is incorrect or incomplete.

Our patients must make a request to amend in writing and include the reasons they believe the information is inaccurate or incomplete.

We are not required to change our patient's health information and will provide them with information about this medical practice's denial and how they can disagree with the denial.

We may deny their request if we do not have the information, if we did not create the information unless the person or entity that created the information is no longer available to make the amendment, if they would not be permitted to inspect or copy the information at issue, or if the information is accurate and complete as is.

If we deny a request, our patients may submit a written statement of their disagreement with that decision, and we may, in turn, prepare a written rebuttal.

Our patients also have the right to request that we add to their record a statement of up to 250 words concerning anything in the record they believe to be incomplete or incorrect.

All information related to any request to amend or supplement will be maintained and disclosed in conjunction with any subsequent disclosure of the disputed information.

5. Right to an Accounting of Disclosures

Our patients have a right to receive an accounting of disclosures of their health information made by this medical practice, except that this medical practice does not have to account for disclosures provided to them or pursuant to their written authorization, or as described in paragraphs 1 (Treatment), 2 (Payment), 3 (Health Care Operations), 6 (Notification and Communication with Family), and 18 (Specialized Government Functions) of Section A of this Notice of Privacy Practices.

Certain disclosures for purposes of research or public health that exclude direct patient identifiers, disclosures that are incidental to a use or disclosure otherwise permitted or authorized by law, or disclosures to a health oversight agency or law enforcement official may also be excluded to the extent permitted by law.

6. Right to Paper Copy of Notice of Privacy Practices

Our patients have a right to notice of our legal duties and privacy practices with respect to their health information, including the right to a paper copy of this Notice of Privacy Practices even if they have previously requested its receipt by email.

If we have a website, we will post our current Notice of Privacy Practices on our website.

D. Changes to This Notice of Privacy Practices

We reserve the right to amend our privacy practices and the terms of this Notice of Privacy Practices at any time in the future.

Until such amendment is made, we are required by law to comply with this Notice.

After an amendment is made, the revised Notice of Privacy Practices will apply to all protected health information that we maintain, regardless of when it was created or received.

We will keep a copy of the current Notice posted in our reception area, and a copy will be available at each appointment.

The current Notice will also be available on our website.

E. Complaints

Complaints about this Notice of Privacy Practices or how this medical practice handles our patients' health information should be directed to our Privacy Officer listed at the top of this Notice of Privacy Practices.

If our patients are not satisfied with the way this office handles a complaint, they may submit a formal complaint to:

Region IX Office for Civil Rights U.S. Department of Health & Human Services 90 7th Street, Suite 4-100 San Francisco, CA 94103 (800) 368-1019 (800) 537-7697 (TDD) (202) 619-3818 (Fax)

Terms & Conditions

Effective Date: September 2026

These Terms & Conditions apply to SMS/text message appointment reminders provided by The California Neuropsychiatric Institute.

SMS/Text Messaging Appointment Reminder Program

By providing a mobile telephone number and consenting to receive text messages from The California Neuropsychiatric Institute, patients may receive SMS/text messages related to their appointments.

Messages may include:

• Appointment reminders

• Appointment confirmations

• Scheduling notifications

• Rescheduling or cancellation information

Participation in our SMS/text messaging program is voluntary.

Message Frequency

Message frequency varies depending on your appointment schedule and interactions with our office.

Message and Data Rates

Message and data rates may apply.

Your wireless carrier's standard messaging and data rates may apply to messages sent or received as part of this service.

Opting Out

You may opt out of receiving appointment reminder text messages at any time by following the opt-out instructions contained in the text messages or by contacting our office.

Opting out of text messages will not affect your ability to receive care from The California Neuropsychiatric Institute.

Customer Care and Assistance

If you need assistance with our appointment reminder text messaging program, please contact:

The California Neuropsychiatric Institute Phone: 909-638-2475 Email: admin@neuropsychinstitute.org

Message Delivery

Wireless carriers are not liable for delayed or undelivered messages.

Delivery of SMS/text messages may be affected by your wireless carrier, network availability, or other circumstances outside the control of The California Neuropsychiatric Institute.

Privacy

We respect the privacy of your mobile information.

No mobile information will be shared with third parties or affiliates for marketing or promotional purposes.

Text messaging originator opt-in data and consent will not be shared with any third parties, excluding aggregators and providers of the Text Message services.

Please review our Notice of Privacy Practices for additional information regarding how we use and protect patient information.