HIPAA Notice of Privacy Practices | PicnicCare Clinic

PicnicCare HIPAA Notice of Privacy Practices

Updated February 13, 2026

This Notice of Privacy Practices (“Notice”) shall apply to the following entities, collectively referred to as “PicnicCare”: PicnicCare, PC, PicnicCare Florida, PA, PicnicCare Kansas, PA, and PicnicCare New Jersey, PC.

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.

We can change the terms of this notice, and the changes will apply to all health information we have about you. The new notice will be available upon request and on our web site

Our Commitment to You

PicnicCare is committed to maintaining the privacy of your health information. As part of our services or during your treatment with us, physicians, nurses, and other personnel may collect information about your health history and current health status. This Notice explains how that information, called “Protected Health Information” (PHI), may be used and disclosed to others. The terms of this Notice apply to health information produced or obtained by PicnicCare.

Our Legal Duties

The HIPAA Privacy Law requires us to provide this Notice to you regarding our privacy practices, our legal duties to protect your health information and your rights concerning health information about you. We are required to follow the privacy practices described in this Notice whenever we use or disclose your PHI. Other companies or persons that perform services on our behalf, called Business Associates, must also protect the privacy of your information. Business Associates are not allowed to release your information to anyone else unless specifically permitted by law.

Uses and Disclosures of Protected Health Information

What Health Information We Collect

As part of our services or during your treatment with us, physicians, nurses, and other personnel may collect information about your health history and current health status. The information we collect is generally protected health information as defined under HIPAA. We collectively refer to this information as health information in this Notice.

How We Use and Disclose Your Health Information

The HIPAA Privacy Law permits PicnicCare to make uses and disclosures of your health information for purposes of treatment, payment and health care operations. Although we are not a substance use disorder (SUD) treatment program, we may receive SUD treatment records about you. The ways in which we use or disclose any information specially-protected under state or federal law, including but not limited to SUD treatment records, mental health information, and HIV/AIDS information, may require your written consent.

We may use or disclose your health information for the purposes outlined in this Notice.

Circumstances Which Require Your Written Consent Prior to Disclosure

For any purpose other than the ones described above, we may only use or share your health information when you give us your written consent or authorization to do so. For example, you will need to sign an authorization form before sending your health information to your life insurance company. You may revoke your authorization, at any time, in writing, except to the extent that we have taken action in reliance on the authorization. We may not use or disclose your health information without an authorization that is valid as per HIPAA Privacy Rule -

Generally, unless otherwise permitted or required by law, before we share your sensitive health information for a purpose other than those permitted by law, we must obtain your written consent or authorization.

Your Rights Regarding Your Health Information

You have certain rights regarding your health information, which are explained below. Unless otherwise specified below, you may exercise these rights by submitting a request in writing to hello@picniccare.com.

We may deny your request for access to your personal information as permitted by HIPAA. For example, we may deny your request if we believe the disclosure will endanger your life or that of another person. Depending on the circumstances of the denial, you may have a right to have this decision reviewed.

You or your personal representative must sign it.

We will agree to a restriction for disclosures to a health plan if (1) the disclosure is for the purpose of carrying out insurance payment or health care operations and (2) the PHI pertains solely to a health care item or service for which you, or a person other than the health plan on your behalf, has paid us in full. For other types of restrictions, we are not required to agree to your request, but we will attempt to accommodate reasonable requests when appropriate. We retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by us, we will notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to restriction. If we agree to the requested restriction, we may not use or disclose your personal information in violation of that restriction unless it is needed to provide emergency treatment or certain other circumstances permitted or required by law.

If we deny your request, we will provide you with a written explanation. You may respond with a statement of disagreement that will be maintained with your records. We will respond to your request within 60 days (with up to a 30-day extension if needed with notice).

This right only applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice. It also excludes disclosures we may have made to you, your family members or friends involved in your care. The right to receive this information is subject to certain exceptions, restrictions and limitations as allowed by HIPAA.

Contact Us

If you believe that we have violated your privacy rights, you may file a complaint with us by notifying us at privacy@picniccare.com. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services if you feel that your rights have been violated. There will be no retaliation from PicnicCare for making a complaint.

Privacy Officer

850 Folsom Street, Suite B

San Francisco, CA 94107

Telephone: (415)-801-0572

Email: privacy@picniccare.com