If you have questions and would like additional information, you may contact the Sansum Clinic Privacy Office by phone at (805) 692-4624 or via fax at (805) 692-4648.
If you believe your privacy rights have been violated, you can file a written complaint with the Privacy Officer at 89 South Patterson Avenue, Santa Barbara, CA 93111, or with the Sansum Clinic Quality Management Department at 470 South Patterson Avenue, Santa Barbara, CA 93111.
Additionally, you may file a complaint with the U. S. Secretary of the Department of Health and Human Services (DHHS), Office for Civil Rights, by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201; by calling (877) 696-6775; or by visiting its official website at www.hhs.gov/ocr/privacy/hipaa/complaints/.
There will be no retaliation for filing a complaint with us or with the Office for Civil Rights.
Effective Date: April 14, 2003
Revision Date: March 29, 2017