Kern County Mental Health is committed to protecting the privacy of the persons receiving mental health and/or substance abuse services from our programs. The Health Insurance Portability and Accountability Act of 1996 (HIPAA), the California Welfare and Institutions Code, and other federal, state and local laws govern how providers must protect patient privacy.

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In order to meet the requirements within those laws, Kern County Mental Health provides this page of privacy-related documents for your information and use.

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Privacy Forms

HIPAA requires us to inform consumers about the rights they have concerning their health information. To view or print a copy of our Privacy Notice, click the link to the right.

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If you want to request a copy of the records created and maintained by Kern County Mental Health, print and complete a Request to Access or Copy Protected Health Information form (coming soon)

If you wish to limit the use and disclosure of your personal health information, print and complete a Request for Restriction of Use or Disclosure of Protected Health Information

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To revoke an authorization, previously granted to this department, print and complete a:

Revocation of Authorization for Release of Protected Health Information

If you want to receive a list of parties who have received your protected health information, without your specific authorization, as allowed by law, print and complete a:

Request for Accounting of Disclosures 

If you believe the records created and maintained by this department are inaccurate or incomplete, you may request an amendment of those records. We may deny this request. To request an amendment, print and complete a:

Request for Amendment of Protected Health Information

If you believe your privacy has been violated through our policies and procedures, by our staff, or if access, amendment, or restriction requests have been denied and you want to make a complaint, print and complete a:

Privacy Complaint Form

Privacy Contact Information

To contact the Kern County Mental Health Privacy Officer:
 

CONFIDENTIAL

Privacy Officer

P.O. Box 1000

Bakersfield, CA 93302

888-875-5559

Programs / Information

• Notice of Privacy Practices

• Notificación Tocante a las Prácticas de Privacidad

• Request for Restriction of Use or Disclosure of Protected Health Information

• Revocation of Authorization for Release of Protected Health Information

• Request for Accounting of Disclosures 

• Request for Amendment of Protected Health Information

• Grievance/Appeal Process

  • Spanish Version​