We are required by law to:

• Maintain the privacy of protected health information.
• Give you this notice of our legal duties and privacy practices regarding health information about you.
• Follow the terms of our notice that is currently in effect.

How We May Use and Disclose Health Information:

• Treatment: We may use and disclose Health Information for your treatment and to provide you with treatment-related health care services.
• Payment: We may use and disclose Health Information so that we or others may bill and receive payment from you, an insurance company, or a third party for treatment and services you receive.
• Health Care Operations: We may use and disclose Health Information for health care operation purposes.
• Appointment Reminders, Treatment Alternatives, and Health Related Benefits and Services: We may use and disclose Health Information to contact you and remind you that you have an appointment with us. We also may use and disclose Health Information to tell you about treatment alternatives or health-related benefits and services that may be of interest to you.
• Individuals Involved in Your Care or Payment for Your Care: We may share Health Information with a person who is involved in your medical care or payment for your care, such as your family or a close friend.

Special Situations:

• As Required by Law: We will disclose Health Information when required to do so by international, federal, state, or local law. If you have any questions about the above notice, please contact our Office at KnowBull Chiropractic 1718 Memorial Drive. Clarksville, TN 37043-4542, 931-444-5955
• To Avert a Serious Threat to Health or Safety: We will disclose Health Information when necessary to prevent a serious threat to your health and safety or the public, or another person.
• Business Associates: We may disclose Health Information to our business associates that perform functions on our behalf or to provide us with services if the information is necessary for such functions or services.
• Organ and Tissue Donation: If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement; banking or transportation of organs, eyes, or tissues to facilitate organ, eye, or tissue donation, and transplantation.
• Military and Veterans: If you are a member of the armed forces, we may release Health Information as required by military command authorities.

Your Rights:

• Right to Inspect and Copy: You have the right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care.
• Right to Amend: If you feel that Health Information we have is incorrect or incomplete, you may ask us to amend the information.
• Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment, and health care operations or for which you provided written authorization.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operations.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about your 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 obtain a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

Changes to This Notice:

• We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a current copy of our notice in our office.

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.