Rooted Functional Medicine

916-619-1112
Privacy Officer: Dr. Adrienne Guthrie, PhD

Effective Date: 1-20-20

Introduction

This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

We are required by both federal law (HIPAA) and California law (CMIA, CCPA/CPRA) to maintain the privacy of your protected health information (“PHI”), provide you with this Notice, and notify you promptly following any breach of unsecured health information. Where California law provides stronger protections than HIPAA, we will follow California law. ✅

How We May Use and Disclose Your Health Information

We may use or disclose your PHI for:

Treatment, Payment, and Health Care Operations (as explained in the original Notice).

Appointment reminders and health-related benefits or services.

Public health and safety reporting as required by law, including child, elder, or dependent adult abuse (CMIA requires disclosure in some cases). ✅

Law enforcement, judicial, and administrative proceedings as permitted by law.

Workers’ compensation to the extent required under California law.

We will not use or disclose your PHI for marketing, sale, or unrelated business purposes without your written authorization. ✅

When We Will Not Use or Disclose Your Health Information

We will not disclose your PHI unless allowed by HIPAA and CMIA, or unless you provide written authorization. You may revoke an authorization at any time in writing.

Your Rights Under HIPAA and California Law

As our client, you have the following rights:

Right to Access, Inspect, and Copy your PHI (in paper or electronic form).

Right to Request Special Restrictions on uses or disclosures.

Right to Request Confidential Communications (e.g., contacting you at an alternate address or phone number).

Right to Amend or Supplement information you believe is inaccurate or incomplete.

Right to an Accounting of Disclosures of your PHI.

Right to a Paper or Electronic Copy of this Notice.

Right to Request Deletion (CCPA/CPRA) – California residents may request deletion of certain personal information collected by us, subject to legal exceptions. ✅

Right to Correct Inaccuracies (CCPA/CPRA) – California residents may request correction of inaccurate information. ✅

Right to Limit Use of Sensitive Information (CCPA/CPRA) – You may request limits on how sensitive personal data (e.g., genetic, biometric, precise geolocation) is used or shared. ✅

Right to Non-Discrimination – You will not be penalized for exercising your privacy rights. ✅

Breach Notification

If a breach of your PHI occurs, we will notify you without unreasonable delay and consistent with California law (CMIA requires notification “as quickly as possible,” HIPAA requires no later than 60 days). ✅

Changes to This Notice

We reserve the right to amend this Notice at any time. Updates will be posted at our office and on our Website. Material changes will include a new effective date.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer using the contact information above.

You may also contact the:

U.S. Department of Health and Human Services Office for Civil Rights at [email protected] or www.hhs.gov/hipaa/filing-a-complaint

California Department of Public Health (CDPH) Privacy Office at cdph.ca.gov ✅

We will not retaliate against you for filing a complaint.