The Student Health Services Program maintains a strict confidentiality and privacy policy to protect your medical information. For more details regarding our policies, please see our Confidentiality Statement and Notice of Privacy Practices below.

Confidentiality Statement

Clients have a right to privacy in Student Health Services. Protected health information (PHI) is confidential and is not part of your academic record. No one on campus has a right to see your PHI or have the knowledge that you are receiving treatment without your written permission. There are legal exceptions to our practices in maintaining confidentiality, which can be viewed under our Notice of Privacy Practices. Aside from these exceptions, only Student Health Services staff may have access to your health related information.

If you have any questions regarding our confidentiality practices, please direct them to the privacy officer/director of Student Health Services at 626-585-7244.

Notice of Privacy Practices

Student Health Services is a confidential clinic and the privacy of each client’s protected health information (PHI) is maintained. With the exception of Student Health Services staff, and specifically noted exceptions, PHI is not accessible to anyone without your written permission.

The law allows Student Health Services to use or disclose health information for treatment, payment, health care operations, notification/communication with family (in emergency circumstances), and health oversight activities. (A paper copy of a full explanation is available upon request).

Explanation of Specific Exceptions:

The law allows us to use or disclose your PHI without written authorization for the following purposes:

1. Required by law:
The law requires us to report abuse, neglect or domestic violence, respond to judicial or administrative proceedings (e.g. subpoenas), or to law enforcement officers (e.g. court orders).

2. Treatment:
We may use or disclose health information about you to provide you with treatment or services.  For example, information may be shared with our doctors, nurse practitioners, physician assistants, nurses, health assistants, and other health care personnel to create and carry out a plan for your treatment.  We may, at your request and with your permission, share information with providers outside of our system who may be involved in your treatment.

3. Health Care Operations:
We may use and disclose health information about you for health care operations.  For example, we may use your information to review the quality of health services you receive. This information is anonymized and is for internal review purposes only.

4. Public health:
On occasion, the law requires us to report a client’s health information to public health authorities for reasons related to: preventing or controlling disease; injury or disability; reporting abuse or neglect; reporting problems with products and reactions to medications to the Food and Drug Administration; and reporting disease or infection exposure.

5. Worker’s Compensation:
We may disclose health information as necessary to comply with worker’s compensation laws. In the case of employees, we report work related injuries to the district business office.

Client Rights

  1. Right to Request Special Privacy Protections:
    You have the right to request restrictions on certain uses and disclosures of your health information. We reserve the right to accept or reject these requests, and will notify you about our decision.

  2. Right to Request Confidential Communications:
    You have the right to request your health information in a specific way or at a specific location. (You may want us to call and leave messages on your cell phone only.) We will comply with reasonable requests submitted in writing.

  3. Right to Inspect and Copy:
    You have the right to inspect or copy your health information.  Student Health Services may charge you a normal duplicating fee. Your health record is destroyed 7 years after your last visit here. There may be limited circumstances for which we would deny your request for access, and this decision will be discussed with you at the time of your request.

  4. Right to Amend or Supplement:
    You have right to amend health information that you believe to be incorrect or incomplete. We reserve the right to deny your request. At your request for amendment, we will review the amendment process.

  5. Right to Accounting of Disclosures:
    You have the right to receive an accounting of certain types of disclosures for the PHI we have made.

  6. Right to Paper Copy of Notice of Privacy Practices:

    You have the right to a paper copy of the Notice of Privacy Practices.

  7. Right to Choose Someone to Act for You:
    You have the right to choose someone to act for you, for example by giving them medical power of attorney.  A legal guardian or person with medical power of attorney can make choices about your health information.  We will verify that this person has authority before we take any action.

  8. Right to Request Us to Share Information:
    You have the right to ask us to share information with your family, close friends or others involved in your care. If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest.

  9. Right to Revoke Your Authorization:
    There may be other disclosures of your health information that will require your written authorization.  You generally have the right to revoke an authorization.

  10. Right to Complain about Violation of Rights:
    If you feel your rights have been violated, you have the right to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, by sending a letter to: 200 Independence Ave., S.W., Room 509F, HHH Building, Washington, DC 20201, calling 1-800-368-1019 or visiting If you are concerned that Student Health Services has violated your privacy rights, or if you disagree with a decision made about access to your records, you also may contact our privacy officer/director (or appointed designee) at 626-585-7244. You will not be penalized for filing a complaint.

Download Authorization to Release Health Information Form