Notice of Privacy Practices

Adopt Chiropractic
1121 Evergreen St, Longview, TX 75604 · (903) 759-5567

Effective date: June 18, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Draft prepared to the standard HIPAA Notice of Privacy Practices structure. Have it reviewed by a healthcare attorney or HIPAA compliance advisor and confirm the Privacy Officer contact details before publishing.

Our commitment

Adopt Chiropractic is required by law to maintain the privacy of your protected health information (PHI), to provide you this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.

How we may use and disclose your health information

Treatment. We use your health information to provide and coordinate your chiropractic care, and may share it with other providers involved in your care.

Payment. We may use and disclose your information to bill and obtain payment for services, including with your insurer if applicable.

Health care operations. We may use your information for quality assessment, training, scheduling, reminders, and general practice operations.

Appointment reminders & communications. We may contact you with appointment reminders or information about your care, using the contact details you provide.

As required or permitted by law. We may disclose information when required by law, for public health and safety, to avoid a serious threat to health or safety, for legal proceedings, or to appropriate authorities in cases of suspected abuse or neglect.

Other uses and disclosures not described in this Notice will be made only with your written authorization, which you may revoke at any time in writing.

Your rights regarding your health information

You have the right to:

• Access — inspect and obtain a copy of your health information.
• Amend — request a correction to information you believe is incorrect or incomplete.
• Accounting of disclosures — request a list of certain disclosures we have made.
• Request restrictions — ask us to limit how we use or share your information (we are not always required to agree).
• Confidential communications — ask us to contact you in a specific way or at a specific location.
• Paper copy — receive a paper copy of this Notice, even if you agreed to receive it electronically.
• File a complaint — without retaliation (see below).

Our duties

We are required to maintain the privacy of your PHI, provide this Notice, abide by its terms, and notify you following a breach of unsecured PHI. We reserve the right to change this Notice and to make the revised Notice effective for information we already have, as well as any information we receive in the future. The current Notice will be posted on our website and available in our office.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.

Privacy Officer / Contact for complaints and requests

Adopt Chiropractic — Privacy Officer
1121 Evergreen St, Longview, TX 75604
(903) 759-5567 · etxchiro@gmail.com