Dear Patient,
Welcome to the office! We are honored you have chosen this office to provide Chiropractic care to you and/or your family. Be assured that we will do everything in our power to give you a very positive experience. Our aim is to get you well and help you meet your health goals...period. Our office mission and guarantee:
“If we can help you, we will tell you. If we cannot help you,
we will tell you that as well and make the proper referral”
Notice of Privacy Practices
In accordance with the Protected Health Information Act (PHI) our office will, without asking your
express consent or authorization, use and disclose your PHI for the purposes of:
- Treatment
- Payment
- Health Care Options
- Advice of Appointments and Services
- Directory/Sign-In Log
- Court Orders, Subpoenas and Government Investigations
- Advise Family/Friends directed by you to receive information regarding your health or
to assist in the payment of your bill.
You have the right to revoke, request special limits or conditions, to receive communication by more confidential means or at alternate locations, to inspect and copy your PHI, and to amend your PHI.
Copies of the NPP may be obtained upon request. Our office strives to maintain HIPAA compliance.
I understand that by signing the above statement I have been notified of my rights in compliance with HIPPA regulations. I have been advised that I may request a complete copy of these rights
available through the HIPAA officer at this location.