Notice of HIPAA Privacy Practices
Last Updated: March 21, 2022
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED BY CityHealth Urgent Care, AND IF APPLICABLE, OUR INDEPENDENT MEDICAL PRACTITIONER PARTNERS (DEFINED BELOW) AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
CityHealth Urgent Care Urgent Care is accountable for its compliance with HIPAA and both are required by law to maintain the privacy of your Protected Health Information.
This Notice of HIPAA Privacy Practices is published on the CityHealth Urgent Care website, in the CityHealth Urgent Care Applications, and is available at all CityHealth Urgent Care clinics
In compliance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) we are required to ask each of our patients to acknowledge receipt of our Notice of HIPAA Privacy Practices.
You acknowledge receipt of the Notice of HIPAA Privacy Practices when you select the “Sign Form” button after being presented these forms during the account creation/sign-up process in the CityHealth Urgent Care patient mobile applications or CityHealth Urgent Care Patient website, or by indicating or signing your acknowledgement in another written or digital format provided to you. You can receive a copy of the Notice of HIPAA Privacy Practices by asking for one at any CityHealth Urgent Care clinic, or by visiting our website and printing the form from there.
Your acknowledging the Notice of HIPAA Privacy Practices is required by HIPAA and CityHealth Urgent Care, and if you do not wish to be bound by this Notice you are not authorized to access or use our Website, Applications, or make use of our healthcare services, and you must promptly exit our Websites or Applications.
CityHealth Urgent Care’s Commitment and Responsibilities
The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) defines strict rules and regulations identifying the controls companies must implement to protect patient privacy, and our responsibility to guard “Protected Health Information” (“PHI”). The information collected when you authenticate to accounts in CityHealth Urgent Care Applications and Websites, or when you communicate with our staff about healthcare matters, whether electronically, orally, or by alternative offline methods, is all considered PHI. PHI includes any and all medical information you share with CityHealth Urgent Care, including your medical history and any medical records from other providers or services you share with us, and also includes more general personal information that may identify you, such as your name, social security number, billing information, addresses, phone numbers, date of birth, and email address.
Your Protected Health Information is kept safe through our commitment to your privacy, and the processes, procedures, controls, and staff training we have in place to ensure our compliance with federal and state laws and regulations.
In keeping with these commitments, we are proud to take responsibility for ensuring that:
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Our Privacy Practices are made available in plain language: ensuring we are transparent when informing you and all recipients of CityHealth Urgent Care products and services of our responsibilities for protecting your PHI.
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We document all of our best practices, company policies, staff procedures, and ensure all staff receive annual training on each, such that all business and healthcare activities are performed with a clear understanding of what is required to keep your data private.
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We follow the practices and procedures defined in this Notice of Privacy Practices
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We are transparent about how in providing our products and services we will use your Protected Health Information.
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We are transparent about your rights to authorize disclosure of Protected Health Information and your rights to revoke those authorizations at any time.
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We remain transparent in our communications with you, disclosing in a timely manner if any problems arise that affect you: informing you directly if a breach occurs (If your PHI is ever mistakenly exposed.)
Additionally, on your behalf CityHealth Urgent Care will always try to apply the strictest protections available on your behalf: we are is committed to adhering not just with federal and individual state regulations, but also to maximizing the protections applied to your data, which we do by applying the more stringent of protections defined by any individual state to all states (unless that causes a direct conflict with your own state’s laws.)
Uses and Disclosures of Protected Healthcare Information
That Do Not Require Your Authorization
We think the title of this section seems much scarier than it is. Our own policies as well as Federal and State regulations have been designed to keep your Protected Health Information private to you. These policies and regulations, including HIPAA, have provisions to support healthcare data sharing that is performed as part of delivering healthcare services: including for treatment, for billing and payment processing, and in healthcare operations. Some sharing is often necessary in order to deliver care: sharing between doctors and a laboratory running tests, between a clinic doctor and your family doctor, between our clinic and a pharmacy, with your health insurance company, etc. HIPAA and the other regulations define exactly when and how data can be shared, and also how that sharing must be securely managed. Examples of use cases where we may use and disclose your PHI without first receiving your authorization include:
Treatment
Your Protected Health Information may be disclosed to:
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Doctors, registered nurses, x-ray technicians and other medical staff working for CityHealth Urgent Care Medical or as Independent Medical Practitioners, who are involved in providing you with healthcare services when they need access to PHI to perform critical parts of their work.
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Medical partners responsible for aspects of your medical care, including lab partners that may be performing tests on samples collected from you, a pharmacy to which a prescription is sent on your behalf, or a Support RN that will follow up with you after a visit to ensure you are feeling better, if and when each may need access to PHI in order to accurately provide you with care.
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Specialists and other healthcare providers responsible for treatments and services not available at the location or time of your visit, and to whom you may be referred, may need access to PHI in order to fulfill their role in your healthcare journey.
Payment
Your Protected Health Information may be disclosed:
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To validate your insurance eligibility and inform you of
your expected out-of-pocket expenses.
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To accept payment or bill you directly for healthcare
services we provide.
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To carry out our obligations and enforce our rights
arising from contracts, including for billing and
collection.
Healthcare Operations
CityHealth Urgent Care strives for the continuous improvement of all aspects of how we deliver healthcare, and Protected Health Information is used in our healthcare operations to help us improve our services and products. PHI may be disclosed
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For the administration and support of our healthcare
services.
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For quality control and quality assurance measures that
help us identify areas in which we can improve our
applications and websites for both staff and patients.
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To support patient inquiries and requests for assistance
associated with how we deliver care.
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To protect against abuses including fraud and waste.
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For review by individuals such as contractors, and our
business associates, including service, that serve a role
in how we deliver our products and services to you. All
contractors, business associates, and other third-party
companies involved in our healthcare operations are also
required to provide protections for your PHI and must also
abide by HIPAA.
Other Purposes
In addition to the reasons above, there exist a few other
reasons why in the best interests of patients, the
community, of for adherence to the law, among other reasons,
that we may find it necessary to use or disclose PHI without
your authorization:
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To protect the safety of an individual or the public when
we think someone may be a victim of abuse, neglect, or
domestic violence, and to protect that person or persons
we believe disclosure to a public health authority or
other appropriate government authority is necessary.
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For public health activities, or health oversight
activities, that may be defined by federal, state, or
county authorities. Examples include efforts to prevent or
control the spread of a disease (as when reporting
Hepatitis A or Covid-19 infections, administered Covid-19
vaccinations), injury, or disability, but also includes
vital events such as births, or deaths where disclosures
of your PHI apply for family arrangements (your
decedents), or "gift of life" purposes (organ, eye, or
tissue donations).
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To avert a threat to individual or public health or
safety: as when we, in good faith, and in compliance with
applicable laws and regulations, believe disclosure to an
appropriate authority will prevent or lessen a serious or
imminent threat to the health of a person or the public;
or when we believe disclosure is necessary to identify or
apprehend an individual that has admitted to a violent
crime that may have caused serious harm or is known to
have escaped from lawful custody.
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For instances where disclosure is required by law,
judicial and administrative proceedings, or for law
enforcement purposes such as when compelled by a court
order or in response to a subpoena, or a government or
regulatory request
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As required for specialized government functions,
including a response to a public health investigation or
public health surveillance activity; when helping to
ensure the quality, safety, or effectiveness of an
FDA-regulated product or activity, including prescription
drugs, medical devices, and supplements; in compliance
with regulatory and oversight agencies for activities
including initial licensure, audits, reviews,
examinations, inspections, investigations.
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To parents and legal guardians overseeing the care of
minors in accordance with applicable laws and regulations.
This may include sharing where parental and legal guardian
consent is required for the services rendered and will
exclude sharing where parental and legal guardian consent
is not required, unless explicit consent in accordance
with applicable laws and regulations is received from the
minor. We will share a minor’s data with a parent or
guardian when required to do so by applicable law.
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As applies to work-related injuries or illness as with
workers’ compensation or similar programs, established by
law, that provide benefits for work-related injuries or
illness without regard to fault.
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To more efficiently communicate with your other care
providers, through our participation in Health Information
Exchanges (HIE) that enable us to share your healthcare
information with other organizations lawfully
participating in treatment, payment, or healthcare
operations involving you. For your protection we provide
opt-in and opt-out rights to you for all HIE in which we
participate, and we do so in accordance with the strictest
interpretation of all applicable federal and state laws.
More About CityHealth Urgent Care’s Operations
There are a number of reasons CityHealth Urgent Care may use your PHI as part of providing our services to you. The most critical of these for us, are in ensuring we are continually conducting quality assessment and improvements of our websites, applications, and staff processes in order to continually improve how we deliver our products and services to you. As part of these efforts we use PHI:
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To present our Websites and Applications, and their
contents to you.
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To provide our healthcare related products and services to
you.
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To answer your requests for information, products, or services from CityHealth Urgent Care, or when we believe it is in your best interest that we inform you of additions and changes to our applications, websites, products, and services.
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To process, fulfill, support, and administer transactions
and orders for products and services you have requested.
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To provide you with notices about your CityHealth Urgent Care Technologies account.
- To administer surveys and solicit feedback.
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To fulfill any purpose for which you have provided PHI on
which we are being asked to act.
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For specific uses described at the time you provide the
information.
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For any other purpose for which you have provided your
authorization as described in "A Note About Your
Authorization to Disclose Protected Health Information"
A Note About Research
While federal and state regulations, including HIPAA, make accommodations for sharing Protected Health Information for research purposes, and this sharing is only allowed with authorized Institutional Review Boards (IRB), and under specific circumstances, CityHealth Urgent Care does not participate in this kind of legal sharing of your PHI without explicitly first requesting then receiving your authorization. We do think this kind of research is important, and that you should know that each IRB is required to protect your PHI, poses minimal risk to your privacy, and can offer great benefits to healthcare research. Choosing to share your data for research purposes, and as a contribution to improving healthcare, is completely voluntary, and you will never be required to share your PHI in order to receive care, and non-participation in research sharing will have no effect on the quality of care you receive.
Uses and Disclosures of Protected Healthcare Information
That Require Your Authorization
CityHealth Urgent Care is committed to your privacy, and this means that your data is protected as yours, and that without your written or electronically signed authorization, your PHI will not be shared outside of the purposes and audiences listed in the preceding sections of this Policy. Other than for the purposes described in this document, we commit that:
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CityHealth Urgent Care will not sell your Protected Health Information.
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CityHealth Urgent Care will not share your Protected Health Information with your employer, unless you grant authorization for such a disclosure.
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CityHealth Urgent Care will not share your Protected Health Information with your school or educational institution, unless you provide an authorization for such a disclosure.
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CityHealth Urgent Care will not use your Protected Health Information for Marketing (We will, as described above, contact you about our own Websites, Applications, products, and services to improve our offerings to you, but we will not let a third party market to you, and we will additionally always allow you to opt-out of even these HIPAA permitted communications that we believe are beneficial to you.)
Additionally, CityHealth Urgent Care abides by all applicable Federal and State laws regarding special protections. As stated above, we apply the most stringent of any one state’s laws to the protections of all state’s patients (save where they conflict with your individual state’s laws and regulations), and this includes the rules governing authorization requirements that must be met prior to sharing Protected Health Information related to:
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Mental health treatment - CityHealth Urgent Care will not share a mental health provider’s process notes save for when covered by the very specific use cases defined by HIPAA.
- Sexual assault
- Sexually transmitted diseases
- Drug and alcohol abuse
- Specific communicable diseases, including HIV/AIDS
A Note About Your Authorization to Disclose Protected Health
Information
Outside of the permitted disclosures described elsewhere in this document, Federal and state laws and regulations, including HIPAA, have very clear rules defining the processes by which any authorization to disclose your Protected Health Information must be requested and received from you. In all cases where your authorization is required, if you have not granted your authorization in accordance with these rules, your information will not be disclosed. Additionally, if you have granted an authorization for a disclosure, it is important that you know you may revoke that authorization at any time. What this means for you, is that unless you see an authorization form meeting the requirements detailed in this section, and unless you choose to sign that form (electronically or by other means), your data will not be shared for any reason outside those identified as permissible elsewhere in this policy. Any request made of you for your authorization to disclose your PHI must clearly, and in plain language provide:
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A description of the information to be used or disclosed
that identifies the information in a specific and
meaningful fashion.
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A name or other specific identification of the person(s),
or class of persons, authorized to make the requested use
or disclosure.
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A name or other specific identification of the person(s),
or class of persons, who will be the recipient of the
requested use or disclosure.
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A description of each purpose for which the requested use
or disclosure is being made. (If you are asking for the
disclosure of your own data, you do not need to explain
your reasons other than to make a statement such as: "At
the request of the individual."
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An expiration date, or expiration event that relates to
the defined individual purpose for which the use or
disclosure is being made. Additionally, if you choose to
contribute to the advancement of healthcare by
participating in a research study, acceptable expiration
statements include: "At the end of the research study",
"none", or similar language.
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A process for receiving your physical or electronic
signature with a recorded signing date. If the
authorization is signed by a personal representative, as
with a Power of Attorney, Parent, or legal Guardian, a
description of the representative’s authority to act for
the individual is also required.
Additionally, the request for authorization to disclose PHI
will specifically state:
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Your right to revoke the authorization, including a description of how you may revoke the authorization, as well as any exceptions to the right to revoke. (Other companies may include this in their Notice of Privacy Practices, but CityHealth Urgent Care Technologies and CityHealth Urgent Care Medical will include this information directly in each authorization form presented for your signature.)
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Our commitment that your authorization to disclose your Protected Health Information will never be required for you to receive healthcare services you acquire directly from us: This protection applies to healthcare services specific to you as an individual. This protection may not apply to services organized by a third party and including you, for example: participation in research studies may require your authorization as a prerequisite for study participation, and similarly, healthcare processes initiated specifically for disclosure to a third party, as with employer funded medical tests for “return to work” purposes, may not be available from CityHealth Urgent Care and the third parties involved, without your authorizing the disclosure for which those activities have been organized.
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The potential for information you authorize to be
disclosed to a third party to end up subject to
redisclosure by that third party, and if that third party
is not required to comply with HIPAA, mention that it is
possible the information will no longer receive the
original protections applied when it was first provided to
your healthcare provider.
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Your right to receive a copy of any authorization you
sign.
Your Rights Regarding Your Protected Health Information
CityHealth Urgent Care will always uphold your rights over the Protected Health Information belonging to you that we may obtain. We will ensure we protect your rights:
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To access your data: We will protect your data, and we
will also ensure that it is available to you.
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To request that we restrict any use and disclosure of your
data. We will not always be able to honor these requests,
and we are not obligated by law or regulation to apply
disclosure restrictions related to our treatment, payment,
or health care operations, save in specific use cases of
payment disclosures to a health plan for services you have
paid in full and where the disclosure is payment related.
This said, where we have documented our ability to comply
with your request, we will honor that commitment in all
cases, save for exceptions defined under HIPAA including
when: We determine that a disclosure is required for
emergency treatment (in that use case we will request that
the party to whom the data is disclosed does not disclose
the information any further); When required by the
Secretary of Health and Human Services
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To receive confidential communications of your Protected
Health Information. We will make this information
available to you in your accounts accessible on our
websites and applications, and you may also request
alternative means of secure communication. We may ask that
you submit such requests in writing, but we will generally
agree to secure alternative communication methods that are
deemed reasonable.
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To inspect and copy your Protected Health Information.
- To request corrections to your data.
- To receive an accounting of disclosures.
- To receive notice of any breach.
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To receive an electronic or paper copy of your PHI with
some restrictions. This may potentially include charging a
reasonable fee associated with the cost of printing and
mailing physical copies.
You can review, copy, and change your Personal Data by logging into our Websites or Applications and visiting either the Settings or Account sections. Additionally, we have provided detailed Contact Information (below) through which you may notify us of any changes or errors in the Personal Data we have about you. We will reply to all such contact to help you ensure that your PHI records are complete, accurate, and as current as possible. If desired, you may also contact us to have us disable or delete your account. For any deletion request, we will make every effort to delete your account and all personal information you have shared with us. Please note that while we will do everything we can to comply with any deletion request, we are not permitted to delete PHI if we believe it would violate any law or legal requirement, or cause the information to be incorrect.
Our commitment to the privacy of your Protected Health
Information, and to transparency in our adherence to this
Notice of Privacy Practices includes our making this notice
available to you on paper when requested through the contact
information below. In protecting your right to receive an
accounting of any disclosures of your Protected Health
Information, we have committed that we will make such an
accounting available covering minimally the 6 years prior to
which the accounting is requested, and covering all
disclosures not otherwise excepted by HIPAA.
A Note About De-identification
Health information that does not identify an individual, and data for which there is no reasonable basis to believe it could be used to identify an individual, including you, represents essentially no usefulness to identity thieves and others involved in criminal practices. While of no value for those with illegitimate motivations, this data represents great value for Healthcare, where providers and researchers employ de-identified data in accordance with the HIPAA safe harbor provision, to both protect the privacy of individuals, and also to protect the health of the many, by identifying critical trends or anomalies in group data as well as studies that follow other research pathways. CityHealth Urgent Care does contribute to healthcare research by making data that has been de-identified in accordance with the safe harbor provision available to trusted research organizations. Safe harbor data is Protected Health Information that as specified by HIPAA has the following 18 individual identifiers removed so that it cannot identify any individual, including you:
- Names
- Social Security Numbers
- Telephone numbers
- Fax numbers
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Geographic subdivisions (including addresses information)
smaller than a state
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All elements of dates (with the exception of year): birth
and death dates, admission dates, discharge dates, ages
for anyone over 89.
- E-Mail addresses
- Medical record numbers
- Health Plan Beneficiary numbers
- Account numbers
- Certificate/license numbers
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Vehicle identification numbers or serial numbers, license
plate numbers
- Device identifiers and serial numbers
- Web Universal Resource Locators (URL)
- Internet Protocol (IP) addresses
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Biometric data (Fingerprints, Face ID, Voice Prints, etc.)
- Full face photographic images and comparable images
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Any other number, characteristic, or code that would
uniquely identify you
In addition to the protections defined throughout this document, CityHealth Urgent Care has committed that we will never share your Protected Health Information if we have any actual knowledge that the information could be used alone or in combination with other information to identify you or any individual who is the subject of the information, unless we have your direct authorization, documented and signed as described in A Note About Your Authorization to Disclose Protected Health Information
Changes to Our Notification of Privacy Practices
We will not weaken the privacy protections applied to your PHI as defined in this Notification of Privacy Practices without first notifying you. We do reserve the right to make changes to this document at any time, so long as those changes do not weaken the privacy protections for which you have initially granted authorization. Changes will apply to all Protected Health Information we maintain. It is our policy to post any changes we make to our Privacy Practices on this page, with a notice that the Privacy Practices has been updated on the Website’s home page or the Application’s home screen. If we want to make material changes to how we treat our users’ Personal Data, we will notify you by email to the email address specified in your account or through a notice on the Website’s home page or the Application’s home screen. The date this Privacy Policy was last revised is identified at the top of the page. You are responsible for ensuring we have an up-to-date, active, and deliverable email address for you, and for periodically accessing the Application or visiting our Website and reviewing this Privacy Practices to check for any changes.
Questions, Concerns, and Complaints
If you have any questions, concerns, complaints or
suggestions regarding our Privacy Practices or otherwise
need to contact us, you may contact us at the contact
information below or through the "Contact Us" page on our
Website or in the Application. In addition to being able to
report complaints to us at any time, if you believe your
privacy rights have been violated or have other concerns,
you may also report complaints to the national Secretary of
Health and Human Services. Any questions, concerns, or
complaints you raise will never be allowed to negatively
affect the quality of care you receive from us, and there
will never be any retaliation against you for any such
filings.
How to Contact Us
CityHealth Urgent Care Attn: 13690 E 14th St., Suite 100 San Leandro, CA 94578 Telephone: (510) 984-2489 Email: [email protected]