HIPAA Notice of Privacy Practices

Effective Date: August 1, 2025

Our Commitment to Your Privacy

ChiroGo is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of your protected health information (PHI) and to provide you with this notice of our legal duties and privacy practices regarding your health information.

How We May Use and Disclose Your Health Information Privacy

Treatment

We may use your health information to provide you with chiropractic treatment and services. We may disclose your health information to other healthcare providers involved in your care, including physicians, physical therapists, and other specialists.

Payment

We may use and disclose your health information to obtain payment for services. This includes submitting claims to your insurance company, verifying coverage, and collecting payment for services rendered.

Healthcare Operations

We may use your health information for healthcare operations, including quality assessment, staff training, licensing, and improving our services.

Other Uses and Disclosures

We may also use or disclose your health information in the following situations:

• As Required by Law: When disclosure is required by federal, state, or local law
• Public Health Activities: To report communicable diseases, injuries, or disabilities as required by Georgia Department of Public Health
• Health Oversight Activities: To state licensing boards or other oversight agencies
• Judicial and Administrative Proceedings: In response to court orders or subpoenas
• Law Enforcement: When required by law enforcement officials
• To Avert Serious Threat: To prevent serious harm to you or others
• Workers’ Compensation: For workers’ compensation claims as permitted by Georgia law

How We May Use and Disclose Your Health Information Privacy

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your health information for treatment, payment, or healthcare operations. We are not required to agree to your request, but if we do, we will comply with your request unless the information is needed for emergency treatment.

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 Inspect and Copy

You have the right to inspect and copy your health information. We may charge a reasonable fee for copying costs. We may deny your request in certain limited circumstances.Right to Inspect and Copy

Right to Amend

You have the right to request that we amend your health information if you believe it is incorrect or incomplete. We may deny your request if we did not create the information or if we believe the information is accurate and complete.

Right to an Accounting

You have the right to request an accounting of disclosures we have made of your health information for purposes other than treatment, payment, and healthcare operations.

Right to a Paper Copy

You have the right to obtain a paper copy of this notice from us at any time.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.

To file a complaint with us:
ChiroGo
Privacy Officer
Email: info@chirogo.solutions

To file a complaint with HHS:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775

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 copy of the current notice at our practice locations and on our website.

Acknowledgment of Receipt

We are required to obtain your acknowledgment that you have received this notice. If you have questions about this notice, please contact our Privacy Officer.