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Your Rights Regarding Your Medical Information

Your medical information is the property of UCSF. You have the following rights, however, regarding medical information we maintain about you:

Right to Inspect and Copy. With certain exceptions, you have the right to inspect and/or receive a copy of your medical information. To inspect and/or to receive a copy of your medical information, you must submit your request in writing to:

Health Information Management Services
UCSF Medical Center and UCSF Benioff Children's Hospital
400 Parnassus Ave., Room A68
San Francisco, CA 94143-0308

If you request a copy of the information, there is a fee for these services. We may deny your request to inspect and/or to receive a copy in certain limited circumstances. If you are denied access to medical information, in most cases, you may have the denial reviewed. Another licensed health care professional chosen by UCSF will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to Request an Amendment or Addendum. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information or add an addendum (addition to the record). You have the right to request an amendment or addendum for as long as the information is kept by or for UCSF.

Amendment. To request an amendment, your request must be made in writing and submitted to:

Patient Relations
UCSF Medical Center and UCSF Benioff Children's Hospital
505 Parnassus Ave., Box 0208, Room M181
San Francisco, CA 94143-0208
Phone: (415) 353-1936
Fax: (415) 353-8556

In addition, you must provide a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

  • Was not created by UCSF
  • Is not part of the medical information kept by or for UCSF
  • Is not part of the information that you are permitted to inspect and copy
  • Is accurate and complete in the record.

Addendum. To submit an addendum, the addendum must be made in writing and submitted to :

Patient Relations
UCSF Medical Center and UCSF Benioff Children's Hospital
505 Parnassus Ave., Box 10 0208, Room M181
San Francisco, CA 94143-0208
Phone: (415) 353-1936
Fax: (415) 353-8556

An addendum must not be longer than 250 words per alleged incomplete or incorrect item in your record.

Right to an Accounting of Disclosures. You have the right to receive a list of the disclosures we have made of your medical information. To request this accounting of disclosures, you must submit your request in writing to :

Health Information Management Services
UCSF Medical Center and UCSF Benioff Children's Hospital
400 Parnassus Ave., Room A68
San Francisco, CA 94143-0308

Your request must state a time period that may not be longer than the six previous years and may not include dates before April 14, 2003.

You are entitled to one accounting within any 12-month period at no cost. If you request a second accounting within that 12-month period, there will be a charge for the cost of compiling the accounting. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information to a family member about your surgery.

To request a restriction, you must make your request in writing to:

Patient Relations
UCSF Medical Center and UCSF Benioff Children's Hospital
505 Parnassus Ave., Box 0208, Room M181
San Francisco, CA 94143-0208

In your request, you must tell us:

  1. What information you want to limit
  2. If you want to limit our use, disclosure or both
  3. To whom you want the limits to apply, for example, only to you and your spouse

We are not required to agree to your request. If we do agree, our agreement must be in writing, and we will comply with your request unless the information is needed to provide you emergency treatment.

Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may ask that we contact you only at work or only by mail.

To request confidential communications, you must make your request in writing to:

Patient Relations
UCSF Medical Center and UCSF Benioff Children's Hospital
505 Parnassus Ave., Box 0208, Room M181
San Francisco, CA 94143-0208

We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of this Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

Copies of this notice are available throughout UCSF.

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Related Information

Contact Us

Patient Relations
Monday to Friday
8:30 a.m. – 5 p.m.
Phone: (415) 353-1936

Weekends and Holidays
Nursing Supervisor
Phone: (415) 353-1797

Send Patient Relations an email.

To review your health information in the Medical Records office, please call (415) 353-2221 to make an appointment from 8 a.m. to 5 p.m., Monday to Friday.