Effective date: [add date]
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.
North Shore Chiropractic is required by law to maintain the privacy of your protected health information (PHI), to provide you with this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
Treatment: We may use your health information to provide and coordinate your chiropractic care. Payment: We may use and disclose your information to bill and obtain payment, including from PIP and other insurers. Health care operations: We may use your information for quality, administrative, and operational purposes. We may also use or disclose information as otherwise permitted or required by law.
You have the right to inspect and copy your health information, request corrections, request an accounting of certain disclosures, request restrictions on how we use or disclose your information, request confidential communications, and receive a paper copy of this notice. You may also file a complaint if you believe your privacy rights have been violated.
We reserve the right to change this notice and to make the revised notice effective for information we already have as well as information we receive in the future. The current notice will be posted in our offices and on this website.
To exercise your rights, ask questions, or file a complaint, contact our Privacy Officer at North Shore Chiropractic, (727) 914-6884. You may also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.