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NOTICE OF PRIVACY PRACTICESRise Family Chiropractic6365 Spalding DrivePeachtree Corners, GA 30092Effective Date: 4-9-26

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

We understand the importance of your privacy and are committed to maintaining the confidentiality of your health information. We create and maintain records of the care we provide to support your health and well-being, ensure quality service, and meet our legal and professional responsibilities.

We are required by law to:
  • Maintain the privacy of your protected health information 
  • Provide you with notice of our legal duties and privacy practices 
  • Notify you following a breach of unsecured protected health information 


This Notice explains how we may use and disclose your information and outlines your rights.

If you have any questions, please contact our Privacy Officer at our office.

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### TABLE OF CONTENTS
  1. How We May Use or Disclose Your Health Information 
  2. When We May Not Use or Disclose Your Health Information 
  3. Your Health Information Rights 
  4. Right to Request Special Privacy Protections 
  5. Right to Request Confidential Communications 
  6. Right to Inspect and Copy 
  7. Right to Amend or Supplement 
  8. Right to an Accounting of Disclosures 
  9. Right to a Paper or Electronic Copy of this Notice 
  10. Changes to This Notice 
  11. Complaints 


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## A. HOW WE MAY USE OR DISCLOSE YOUR HEALTH INFORMATION

Our practice collects health information and maintains it in your record. While the record itself is the property of this practice, the information belongs to you.

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

### 1. Care (Treatment)We use your health information to provide chiropractic care focused on improving nervous system function and overall health.

We may share information with team members or other health care providers involved in your care. For example, we may communicate with another provider, laboratory, or specialist as needed to support your care.

We may also share information with family members or others involved in your care when appropriate.

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### 2. PaymentWe may use and disclose your information to obtain payment for services. This may include sharing necessary information with your health plan or other providers involved in your care.

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### 3. Health Care OperationsWe may use your information to operate and improve our practice. This includes:
  • Quality assessment and improvement 
  • Staff training and evaluation 
  • Business planning and management 
  • Compliance with legal and regulatory requirements 


We may share information with trusted business partners (“business associates”) who assist in operations, under strict confidentiality agreements.

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### 4. Appointment RemindersWe may contact you to remind you about upcoming visits.

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### 5. Sign-In and Office FlowWe may ask you to sign in when you arrive and may call your name when we are ready to see you.

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### 6. Communication with FamilyWe may share relevant information with family members or others involved in your care unless you object.

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### 7. Health-Related CommunicationWe may contact you with information related to your care, recommendations, or services that may support your health and well-being. We will not use your information for marketing without your written authorization.

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### 8. Sale of Health InformationWe will not sell your health information without your written authorization.

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### 9. Required by LawWe will disclose your information when required by law.

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### 10. Public HealthWe may disclose information to public health authorities for purposes such as:
  • Preventing disease 
  • Reporting abuse or neglect 
  • Monitoring safety of products or medications 


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### 11. Health OversightWe may disclose information to oversight agencies for audits, inspections, or licensing.

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### 12. Legal ProceedingsWe may disclose information in response to court orders or legal processes.

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### 13. Law EnforcementWe may disclose information to law enforcement as required by law.

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### 14. Coroners and Medical ExaminersWe may disclose information related to investigations of death.

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### 15. Organ DonationWe may share information with organizations involved in organ or tissue donation.

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### 16. Public SafetyWe may disclose information to prevent serious threats to health or safety.

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### 17. Specialized Government FunctionsWe may disclose information for military, national security, or correctional purposes.

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### 18. Workers’ CompensationWe may disclose information as required for workers’ compensation claims.

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### 19. Change of OwnershipIf this practice is sold or merged, your information may be transferred to the new owner.

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### 20. Breach NotificationIf a breach occurs, we will notify you as required by law.

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## B. WHEN WE MAY NOT USE OR DISCLOSE YOUR INFORMATION

Except as described in this Notice, we will not use or disclose your information without your written authorization. You may revoke authorization at any time.

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## C. YOUR HEALTH INFORMATION RIGHTS

You have the following rights:

### 1. Request RestrictionsYou may request limits on how your information is used or disclosed. We are not required to agree to all requests.

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### 2. Confidential CommunicationsYou may request that we communicate with you in a specific way or location.

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### 3. Inspect and CopyYou may request access to your records. Reasonable fees may apply.

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### 4. Amend Your RecordYou may request corrections to your information if you believe it is incorrect or incomplete.

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### 5. Accounting of DisclosuresYou may request a list of certain disclosures we have made.

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### 6. Copy of This NoticeYou may request a paper or electronic copy of this Notice at any time.

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## D. CHANGES TO THIS NOTICE

We may update this Notice at any time. The updated version will apply to all information we maintain and will be available in our office and on our website.

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## E. COMPLAINTS

If you have concerns about your privacy, please contact our office.

You may also file a complaint with the U.S. Department of Health and Human Services:OCRMail@hhs.gov https://www.hhs.gov/hipaa/filing-a-complaint/