Effective Date: August 8, 2013 | Revised: July 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.
Scenic City Clinic of Chiropractic is required by law to maintain the privacy of your protected health information (“PHI”), to provide you with this Notice describing our legal duties and privacy practices with respect to your PHI, and to notify you following a breach of unsecured PHI. We are required to abide by the terms of this Notice while it is in effect.
How We May Use and Disclose Your Health Information
We may use and disclose your PHI for the following purposes without your written authorization:
- Treatment — to provide, coordinate, or manage your chiropractic care and related services, including sharing information with other doctors or providers involved in your care.
- Payment — to bill and collect payment for the services you receive from us, including verifying coverage and processing claims.
- Healthcare Operations — for activities such as quality assessment, staff training, and business management.
- Appointment Reminders and Treatment Alternatives — to contact you with appointment reminders or information about treatment options or health-related benefits and services that may be of interest to you.
- As Required by Law — when disclosure is required by federal, state, or local law.
- Public Health and Safety — to public health authorities, for reporting abuse or neglect, or to avert a serious and imminent threat to health or safety.
- Health Oversight, Judicial, and Law Enforcement Purposes — for activities authorized by law, including audits, investigations, and in response to a court order, subpoena, or other lawful process.
- Workers’ Compensation — as authorized by and to the extent necessary to comply with workers’ compensation laws.
- Business Associates — to third parties who perform services on our behalf (such as billing or IT services) under a written agreement requiring them to safeguard your information.
Uses and Disclosures Requiring Your Written Authorization
Other than as described above, we will not use or disclose your PHI without your written authorization, including for most marketing purposes and any sale of your PHI. You may revoke a prior authorization, in writing, at any time.
Substance Use Disorder Records (42 CFR Part 2)
If we create, receive, or maintain records that are protected under 42 CFR Part 2 (federal confidentiality regulations for substance use disorder treatment records), those records are subject to additional federal privacy protections beyond standard HIPAA protections. Such records generally may not be disclosed or used to investigate or prosecute a patient in connection with a criminal or civil proceeding without patient consent or a qualifying court order. You have the right to file a complaint with the U.S. Department of Health and Human Services if you believe your Part 2-protected information has been used or disclosed in violation of these protections, using the contact information below.
Your Rights Regarding Your Health Information
You have the right to:
- Request Restrictions — ask us to limit how we use or disclose your PHI, including the right to request that we not disclose information to your health plan for services you paid for in full out-of-pocket. We are not required to agree to all restriction requests, except this one, which we must honor.
- Request Confidential Communications — ask us to contact you in a specific way or at a specific location.
- Inspect and Copy — request access to and a copy of your PHI in our records, including an electronic copy where readily producible.
- Request Amendment — ask us to amend your PHI if you believe it is incorrect or incomplete.
- Receive an Accounting of Disclosures — request a list of certain disclosures of your PHI made by us.
- Receive a Paper Copy of This Notice — request a paper copy of this Notice at any time, even if you agreed to receive it electronically.
- Be Notified of a Breach — receive notification if there is a breach of your unsecured PHI.
- File a Complaint — file a complaint with us or with the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint.
Our Responsibilities
We are required by law to maintain the privacy of your PHI, provide you with this Notice, abide by its terms, and notify you if a breach of your unsecured PHI occurs. We reserve the right to change the terms of this Notice and to make the revised Notice effective for PHI we already have as well as any information we receive in the future. We will post a copy of the current Notice in our office and on our website.
Contact Information / Privacy Officer
If you have questions about this Notice, or wish to exercise any of the rights described above, please contact:
Scenic City Clinic of Chiropractic
7530 Goodwin Road, Chattanooga, TN 37421
Phone: (423) 402-4602
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)