Notice of Privacy Practices  

 Adler Comprehensive Chiropractic, LCC  – Roswell, GA  

Effective Date: 1/19/2025

This notice describes how your medical information may be used and disclosed and how you can access this information.Please review it carefully.

Our Commitment to Your Privacy 

At Adler Comprehensive Chiropractic, LCC , we value your privacy and are committed to protecting your medical information. Our records help us provide the highest quality of care and ensure that we meet legal and professional standards. This notice outlines how we use and disclose yourProtected Health Information (PHI) and your rights regarding your medical records.  

We are required by law to:  

– Maintain the privacy of your health information.  

– Provide you with this notice of our legal duties and privacy practices.  

– Notify you in the event of a breach of your unsecured PHI.  

How We May Use and Disclose Your Health Information  

1. Treatment  

We use your medical information to provide care, coordinate treatment, and communicate with other healthcare professionals. This may include:  

– Sharing necessary information with specialists, physical therapists, or labs.  

– Discussing your condition with other providers involved in your care.  

2. Payment  

We may use and disclose your health information to bill and collect payment from:  

– Your insurance company.  

– Workers’ compensation providers.  

– Any third-party payer assisting with your treatment coverage.  

3. Healthcare Operations  

We use your information for administrative and operational purposes, including:  

– Reviewing our services for quality improvement.  

– Training staff and ensuring compliance with healthcare regulations.  

– Verifying insurance coverage and pre-approvals.  

4. Appointment Reminders  

We may contact you via phone, email, or text message to remind you about upcoming appointments. If you prefer a specific method of communication, please let us know.  

5. Family Notification & Emergency Situations  

Unless you object, we may share general health information with family members or individuals involved in your care. In emergencies, we may share relevant information with first responders or healthcare professionals to ensure proper treatment.  

6. Public Health & Legal Obligations  

In certain situations, we may be required to disclose your health information, including:  

– Reporting infectious diseases or exposure.  

– Complying with law enforcement, court orders, or subpoenas.  

– Assisting with public safety concerns, such as abuse, neglect, or workplace injuries.  

7. Marketing & Communications  

We may contact you with information about health-related services, chiropractic treatments, or community wellness programs relevant to your care. However, we will not sell or share your medical information for marketing purposes without your written consent.  

Your Rights Regarding Your Health Information  

As a patient, you have the following rights:

1. Right to Request Restrictions  

You may request limitations on how we use or share your medical information. While we are not required to accept all requests, we will comply when possible.  

2. Right to Confidential Communication  

You may ask us to contact you at a specific address, phone number, or email for greater privacy.  

3. Right to Access & Copy Your Records  

You have the right to view and request a copy of your medical records. A reasonable fee may apply for printed or electronic copies.  

4. Right to Amend Your Records  

If you believe your medical records are incomplete or incorrect, you may request an amendment in writing. We will review your request and respond within30 days.  

5. Right to an Accounting of Disclosures  

You may request a list of instances where we shared your health information for reasons other than treatment, payment, or healthcare operations.  

6. Right to a Copy of This Notice  

You may request apaper or electronic copy of this privacy notice at any time. A copy is always available at our office or on our website.  

Changes to This Privacy Policy  

We may update this notice as required by law. The current version will always be available in our office and on our website. Any changes will apply to past, present, and future medical information.  

Filing a Complaint  

If you believe your privacy rights have been violated, you may file a complaint with:  

 Adler Comprehensive Chiropractic, LCC 

[email protected]

You may also file a complaint with theU.S. Department of Health & Human Services (HHS). Filing a complaint will not affect your care or treatment.  

Thank you for trusting  Adler Comprehensive Chiropractic, LCC  with your healthcare needs. We are dedicated to protecting your privacy while providing exceptional care.  

 Adler Comprehensive Chiropractic, LCC  – Roswell, GA   

 AdlerChiro.com