Effective Date: 12/20/2024

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

Your Rights

You have rights regarding your health information, including the right to:

  • Access and Obtain Copies: Request access to your medical records, including electronic health records (EHRs), and receive a copy within 15 days of your request.
  • Request Corrections: Ask us to correct any incorrect or incomplete information in your records.
  • Restrict Disclosures: Request additional restrictions on certain uses or disclosures, including those related to reproductive health information.
  • Confidential Communications: Request contact via a specific address, phone number, or method of communication.
  • File Complaints: File a complaint with us or the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. Filing a complaint will not affect the care you receive.

Your Choices

You may choose how we use or share your health information:

  • Authorize Sharing of Information: Decide whether we share your protected health information (PHI) with family, friends, or others involved in your care.
  • Receive Communications About Services: Opt in to receive news, reminders, and promotions via email or text.

 

Our Responsibilities

We are required by law to:

  • Protect your personal and medical information.
  • Inform you if a breach occurs that compromises your information.
  • Use or disclose your information only as described in this Notice or as required by law.

 

Uses and Disclosures

We may use or share your health information for:

  • Treatment: To provide and coordinate your healthcare.
  • Payment: To bill and collect payment for the services you receive.
  • Healthcare Operations: To improve services and conduct essential business functions.
  • Public Health and Safety: To report on public health issues or comply with legal obligations.
  • Reproductive Health Privacy: Reproductive health information will only be disclosed with your explicit written consent, except as required by law.

Reproductive Health Privacy

Under the HIPAA Privacy Rule, your reproductive health information is subject to enhanced protections.

  • Your Rights: You may request restrictions on the use or sharing of this information.
  • Our Obligations: We will not disclose reproductive health information without your consent, except as required by law or for treatment, payment, or healthcare operations.

Filing Complaints

If you believe your privacy rights have been violated, you may contact:

  • Privacy Officer: Dr. Diane L. Garman, DC, RN
  • Phone: 585-377-5890
  • Fax: 585-377-5899
  • Email: garmanchiro@gmail.com
  • Address: Garman Chiropractic, 25 George St, Fairport, NY 14450

You may also file a complaint directly with the U.S. Department of Health and Human Services. Filing a complaint will not affect your care.

Changes to This Notice

We may update this Notice periodically. The updated version will be posted on our website and available in our office.

Contact Us

For questions about this Notice or your rights, contact us at:

  • Phone: 585-377-5890
  • Fax: 585-377-5899
  • Email: garmanchiro@gmail.com
  • Website: www.garmanchiro.com
  • Address: Garman Chiropractic, 25 George St, Fairport, NY 14450