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.
Effective date
[Insert the practice’s approved Notice of Privacy Practices]
How we may use and disclose your health information
[Insert the practice’s approved Notice of Privacy Practices]
Your rights
[Insert the practice’s approved Notice of Privacy Practices]
Your choices
[Insert the practice’s approved Notice of Privacy Practices]
Our duties
[Insert the practice’s approved Notice of Privacy Practices]
Changes to this notice
[Insert the practice’s approved Notice of Privacy Practices]
How to file a complaint
[Insert the practice’s approved Notice of Privacy Practices]
Contact our Privacy Officer
[Insert the practice’s approved Notice of Privacy Practices]
[Privacy Officer name], Privacy OfficerChiropractic Company
[Mailing address]
[Phone] · [Email]
Get a copy of this notice
Download the notice (PDF). You can also ask for a paper copy at any of our clinics.
Need it in another language or format? See our nondiscrimination notice.