Our Commitment to Your Privacy

This Notice of Privacy Practices describes how Palmer Chiropractic may use and disclose your protected health information (PHI) to carry out treatment, payment, or health care operations (TPO) and for other purposes that are permitted or required by law. "Protected Health Information" is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related care services.

How We May Use and Disclose Your Protected Health Information

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you, or to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.

Healthcare Operations: We may disclose, as needed, your protected health information in order to support the business activities of our practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, marketing, and fund-raising activities, and conducting or arranging for other business activities. We may also use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may call you by name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment.

Other Permitted and Required Uses and Disclosures

We are also permitted or required by law to make disclosures of your health information without your consent or authorization in the following circumstances:

• As required by law, including public health activities
• Communicable diseases and health oversight
• Abuse or neglect reporting
• Food and drug administration requirements
• Legal proceedings and law enforcement
• Coroners, funeral directors, and organ donation
• Research purposes (with appropriate protections)
• To avert a serious threat to health or safety
• Military activity, national security, and protective services
• Workers' compensation

Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law. You may revoke this authorization, at any time, in writing, except to the extent that your physician or the practice has taken an action in reliance on the use or disclosure indicated in the authorization.

Your Rights Regarding Your Protected Health Information

• Right to Inspect and Copy: You have the right to inspect and copy your protected health information. To access your medical information, you must submit a written request to our office.
• Right to Amend: If you believe the health information we have about you is incorrect or incomplete, you may ask us to amend the information.
• Right to an Accounting of Disclosures: You have the right to request an accounting of disclosures of your protected health information made by this practice.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
• Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.

Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our office. The notice will contain on the first page, in the top right-hand corner, the effective date.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact us at:

Palmer Chiropractic
24837 104th Ave SE Suite 100, Kent, WA 98030
Phone: (253) 854-7700

You will not be penalized for filing a complaint.