The City’s administrative offices will be closed from Monday, December 25 – Monday, January 1. 24-hour operations will remain in effect for the Police and Fire Departments. Some facilities will be open at full or limited hours. Get more information.

Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review carefully.  

We required by law to maintain the privacy of certain “Protected Health Information” or “PHI”, to provide you with a Notice of Privacy Practices explaining our legal duties & privacy practices with respect to your PHI, and to abide by the terms of the notice currently in effect.

Uses and disclosures of your Protected Health Information (PHI)

We may use or disclose your PHI without your authorization, or without providing you with an opportunity to object, for the following purposes:

  • Treatment: This includes any verbal and written information that we obtain about you and use pertaining to your medical condition and treatment provided to you by us and other medical personnel. It also includes any information we give to other healthcare personnel to whom we transfer your care and treatment, transfer of PHI via radio or telephone to the hospital or dispatch center, and providing the hospital with a copy of the written record we create in the course of providing you with treatment and transport.
  • Payment: This includes any activities we must undertake to get reimbursed for the services that we provide to you, including submitting bills to insurance companies, managing billed claims for services rendered, performing medical necessity determinations and collecting outstanding accounts.
  • Health Care Operations: This includes quality assurance activities, licensing, and training programs to ensure that our personnel meet our standards of care and follow established policies and procedures. It includes obtaining legal and financial services, conducting business planning, processing grievances and complaints, and creating reports that do not individually identify you for data collection purposes.

Other uses and disclosures of PHI permitted or required by law

  • For healthcare fraud and abuse detection or for activities related to compliance with the law;
  • To communicate with individuals that are directly involved in your care;
  • To a public health authority as part of a public health investigation, to report child or adult abuse, neglect or domestic violence, or to notify a person about exposure to a possible communicable disease, as required by law;
  • For health oversight activities undertaken by the government by law to oversee the healthcare system;
  • For judicial proceedings as required by a court or an administrative order, or in response to a subpoena;
  • For law enforcement activities in limited situations, such as when there is as a warrant for the request, or when the information is needed to locate a suspect or stop a crime;
  • For military, national defense and security and other special government functions;
  • To coroners, medical examiners, and funeral directors for identifying a deceased person, determining cause of death, or carrying on their duties as authorized by law; and
  • Other uses and disclosures as permitted or required by law including worker’s compensation law.

All other uses and disclosures of PHI will be made only with your authorization. You have the right to revoke such authorization at any time, in writing, except to the extent that we have already used or disclosed PHI in reliance on that authorization.

Patient rights regarding your PHI

  • You have the right to access, copy or inspect your PHI.
  • You have the right to amend your PHI. We are permitted by law to deny your request to amend your medical information if we believe that the information you have asked us to amend is correct.
  • You have the right to an accounting of uses and disclosures of your PHI.
  • You have the right to request restrictions on uses and disclosure of your PHI. We are only required to abide by a requested restriction under limited circumstances.
  • You have the right to a notice of breach of unsecured PHI.
  • You have the right to receive confidential communications of your PHI.
  • You have the right to complain to us, or to the Secretary of the United States Department of Health and Human Services, if you believe that your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with us or to the government.

Internet, email and the right to obtain copy of paper notice

If you request and provide us with your contact information, we will forward you a copy of this Notice by email or regular mail, and you also may obtain a copy by coming by our offices.

Revisions to the Notice

We are required to abide by the terms of the version of this Notice currently in effect.  However, the we reserve the right to change the terms of this Notice at any time, and the changes will be effective immediately and will apply to all PHI that we maintain. You can obtain the latest version of this Notice on our website or by contacting our HIPAA Compliance Officer.

Your Legal Rights and Complaints

If you have any questions about your PHI or if you wish to file a complaint or exercise any rights listed in this Notice, you may contact the City of San Rafael Fire Department’s HIPAA Compliance Officer at:

City of San Rafael Fire Department,
HIPAA Compliance Officer,
1039 C Street, San Rafael, CA 94901,

(415) 485-3304

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