Effective Date: April 14,2003

Berkeley Mental Health values your privacy and will protect mental health information about you or your child. The complete Notice of Privacy Practices tells you in detail about how we safeguard your mental health information. PLEASE REVIEW IT CAREFULLY.

“Use” means the sharing and using of information by Berkeley Mental Health staff.

“Disclosure” is the release of information by us to others outside of Berkeley Mental Health.

“Authorization” is you giving us written permission to release your information to you or to other persons.

By law, you have the legal right to:

Berkeley Mental Health may release information needed for treatment, payment or our own business operations without your authorization.

The Notice of Privacy Practices will tell you:

Berkeley Mental Health pledges that we will follow the Notice of Privacy Practices. It will be posted at all mental health sites, and if any part of it changes, new notices will be available.

If you have any questions about your privacy rights, please contact your clinician.