Back To Health Chiropractic

3075 W 7800 S, West Jordan, UT 84088

Jon Christensen, D.C., M.A.O.M. - (801) 565-9500

Effective Date: 08/08/2013

THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED, DISCLOSED, AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

At Back To Health Chiropractic, protecting your privacy is important. This Notice outlines how we handle your protected health information (PHI) and your rights regarding your health information.

How We May Use or Disclose Your Health Information

We may use your health information for the following purposes:

Treatment: Providing and coordinating your chiropractic care and related services.

Payment: Obtaining payment for services rendered to you from your insurance or health plan.

Health Care Operations: Operating our practice, including improving care quality, evaluating staff performance, and administrative functions.

Appointment Reminders: Contacting you to remind you of appointments.

Family Notification: Communicating with family members or others involved in your care, in emergency or critical situations.

Required by Law: Complying with legal obligations, reporting requirements, judicial proceedings, law enforcement requests, and public health activities.

Public Safety: Disclosing information to prevent or reduce serious threats to health or safety.

Workers' Compensation: Complying with applicable workers’ compensation laws.

Business Transitions: Your records may transfer ownership if our practice is sold or merged.

We will not sell your health information without your explicit written authorization.

Your Rights Regarding Your Health Information

You have several important rights concerning your health information:

Inspect and Copy: Request and receive copies of your health information.

Amend or Correct: Request corrections to incomplete or inaccurate information.

Request Restrictions: Request restrictions on how your information is used or shared for treatment, payment, or operations.

Confidential Communications: Request that communications be sent to you confidentially (e.g., to a specific address or phone number).

Accounting of Disclosures: Request a list of certain disclosures we have made of your health information.

Receive a Copy of This Notice: Obtain a paper or electronic copy of this privacy notice at any time.

To exercise any of these rights, please contact our Privacy Officer listed above.

Our Responsibilities

We are legally required to:

* Protect the privacy and security of your health information.

* Provide you with this notice outlining our privacy practices.

* Abide by the terms currently in effect in this notice.

* Notify you promptly if a breach of unsecured health information occurs.

Changes to This Notice

We reserve the right to revise this notice at any time. Any revised notice will be made available in our reception area, provided at your appointment, and posted on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer listed above or directly with the U.S. Department of Health and Human Services Office for Civil Rights:

Email: [email protected]

Online: hhs.gov/hipaa/filing-a-complaint

You will not be penalized or face retaliation for filing a complaint.