NOTICE OF PRIVACY PRACTICES

Dr. Viet-Hong Bui Clinic

696 E. Santa Clara St., Suite 210

San Jose, CA 95112

Telephone: (408) 295-9839 Effective Date: December 14, 2025

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Pledge Regarding Medical Information

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at Dr. Viet-Hong Bui Clinic to provide you with quality care and to comply with certain legal requirements.

This Notice applies to all of the records of your care generated by this clinic. We are required by law to:

Make sure that medical information that identifies you is kept private (Protected Health Information or "PHI").
Give you this Notice of our legal duties and privacy practices with respect to medical information about you.
Follow the terms of the Notice that is currently in effect.
Notify you in the event of a breach of your unsecured PHI.

How We May Use and Disclose Medical Information About You

The following categories describe different ways that we use and disclose medical information.

1. For Treatment, Payment, and Health Care Operations

For Treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, or other personnel who are involved in your care. For example, we may share your information with a specialist to whom you have been referred, or with a pharmacy to fill a prescription.
For Payment: We may use and disclose medical information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party.
For Health Care Operations: We may use and disclose medical information about you for our practice operations. These uses and disclosures are necessary to run the clinic and make sure that all of our patients receive quality care (e.g., internal audits, quality assessment).

2. Situations Where We Do Not Need Your Authorization

We may use or disclose your health information without your permission in the following circumstances, subject to applicable California and Federal laws:

Required By Law: When required to do so by federal, state, or local law.
Public Health Activities: For prevention or control of disease, injury, or disability; reporting births and deaths; reporting child abuse or neglect; and reporting reactions to medications.
Health Oversight Activities: To a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure.
Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement: To law enforcement officials for reporting specific types of wounds or physical injuries, or in response to a court order, subpoena, warrant, summons, or similar process.
Coroners, Medical Examiners, and Funeral Directors: To identify a deceased person or determine the cause of death.
Organ and Tissue Donation: If you are an organ donor, we may release information to organizations that handle organ procurement.
To Avert a Serious Threat to Health or Safety: To prevent a serious threat to your health and safety or the health and safety of the public or another person.
Workers' Compensation: To comply with laws relating to workers' compensation or similar programs.

3. California Law

California law may provide you with additional protections regarding your health information (e.g., HIV/AIDS information, mental health records, and substance abuse records). Where California law is more protective of your privacy than federal law (HIPAA), we will abide by the stricter California law.

Your Rights Regarding Medical Information About You

You have the following rights regarding medical information we maintain about you:

Right to Inspect and Copy: You have the right to inspect and obtain a copy of medical information that may be used to make decisions about your care. Usually, this includes medical and billing records. To inspect and copy medical information, you must submit your request in writing. We may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.
Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by the clinic. You must provide a reason that supports your request. We may deny your request if the information is accurate and complete.
Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you, excluding disclosures for treatment, payment, and health care operations.
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. We are not required to agree to your request, unless you are asking us to restrict the use and disclosure of your PHI to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid us "out-of-pocket" in full.
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 (e.g., only at work or by mail).
Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice at any time, even if you have agreed to receive this notice electronically.

Changes to This Notice

We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice in the clinic. The Notice will contain the effective date on the first page.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our clinic or with the Secretary of the U.S. Department of Health and Human Services (OCR).

To file a complaint with the clinic, contact:

Dr. Viet-Hong Bui

696 E. Santa Clara St., Suite 210

San Jose, CA 95112

(408) 295-9839

You will not be penalized or retaliated against for filing a complaint.