Effective Date: February 16, 2026
Original Publication Date: January 2, 2003
Revision Date(s): September 22, 2004, April 23, 2014, February 6, 2025

124 S. Church St., Hudson, MI 49247 | (517) 448-3791
122 Walnut St., P.O. Box 347, Reading, MI 49274 | (517) 283-2339
Website: www.healthchiro.com
Privacy Officer: Michelle Spencer | mspencercfh@gmail.com

YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.

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

YOUR RIGHTS

You have the right to:

  • Get a copy of your paper or electronic medical record • Request a correction to your medical record
  • Request confidential communications
  • Ask us to limit the information we share
  • Receive an accounting of disclosures
  • Obtain a paper copy of this Notice
  • Choose someone to act on your behalf
  • File a complaint without retaliation

YOUR RIGHTS IN DETAIL

Access to Records: You may inspect or obtain a copy of your protected health information (PHI). We will respond within 30 days. A reasonable cost-based fee may apply.

Amendment: You may request correction of inaccurate or incomplete information. We may deny your request in writing within 60 days if permitted by law.

Confidential Communications: You may request that we contact you in a specific way or at a specific location. We will accommodate reasonable requests.

Restrictions: You may request restrictions on certain uses or disclosures. We are not required to agree except when you pay in full out-of-pocket and request restriction from your health plan.

Accounting of Disclosures: You may request a list of disclosures made during the prior six years, excluding treatment, payment, and healthcare operations. One accounting per year is free.

Personal Representatives: If someone has legal authority to act for you under Michigan law, we will verify that authority before honoring requests.

SPECIAL PROTECTIONS UNDER MICHIGAN LAW

Certain health information may be subject to additional protections under Michigan law, including mental health records, communicable disease information, and information concerning minors who consent to treatment under the Michigan Public Health Code. When Michigan law is more protective than federal law, we follow Michigan law.

In circumstances where a minor has the legal authority to consent to treatment under Michigan law, that minor may control access to related health information.

REPRODUCTIVE HEALTH INFORMATION PROTECTIONS (2024 HIPAA RULE)

We will not use or disclose your protected health information for the purpose of investigating or imposing liability on any person for the lawful provision, receipt, or facilitation of reproductive health care, nor will we disclose such information to identify a person for such purposes, except as required by federal law.

SUBSTANCE USE DISORDER RECORDS (42 CFR PART 2)

If we maintain substance use disorder treatment records subject to 42 CFR Part 2, those records are protected by federal law. Such information will not be used or disclosed without your written consent except as permitted by law. These records may not be redisclosed without specific authorization unless otherwise allowed under federal regulations.

HOW WE MAY USE AND DISCLOSE YOUR INFORMATION

  • Treatment: We may share information with healthcare providers involved in your care.
  • Payment: We may use and disclose information to obtain payment from insurers or other responsible parties.
  • Healthcare Operations: We may use information to operate and improve our practice.
  • Appointment Reminders: We may contact you by phone, voicemail, text, email, or patient portal regarding appointments or billing matters.
  • Public Health and Safety: We may disclose information to prevent disease, report abuse or neglect, or reduce serious threats to health or safety.
  • Health Oversight Activities: We may disclose information to government agencies conducting audits or investigations.
  • Legal Proceedings: We may disclose information in response to court orders or lawful subpoenas.
  • Workers’ Compensation: We may disclose information as authorized by workers’ compensation laws.

OUR RESPONSIBILITIES

We are required by law to maintain the privacy and security of your protected health information. We maintain administrative, technical, and physical safeguards designed to protect your information.

We will notify you promptly if a breach occurs that may compromise your information.

We will follow the practices described in this Notice and will not use or disclose your information other than as described unless you authorize us in writing. You may revoke authorization at any time in writing.

COMPLAINTS

If you believe your privacy rights have been violated, you may contact our Privacy Officer listed above. You may also contact the Michigan Association of Chiropractors at 1-800-949-1401.

You have the right to file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at:

200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775
Website: https://www.hhs.gov/hipaa/filing-a-complaint/index.html We will not retaliate against you for filing a complaint.

CHANGES TO THIS NOTICE

We reserve the right to change this Notice. Any revised Notice will apply to all information we maintain and will be available in our office and on our website.