Notice of Privacy Practices

Effective: May 27, 2026.

Our Pledge Regarding Your Health Information

Georgia Spine and Sports Rehab is committed to protecting the privacy of your health information. We are required by federal and state law to maintain the privacy of your Protected Health Information (PHI), to provide you with this notice of our legal duties and privacy practices, and to follow the terms of this notice.

How We May Use and Disclose Your Health Information

The following describes the ways we may use and disclose your PHI without your written authorization. Examples are illustrative, not exhaustive.

For Treatment

We use and disclose your PHI to provide, coordinate, or manage your chiropractic and sports rehabilitation care. For example, we may share your records with another provider you are referred to (an orthopedist, primary care physician, physical therapist, or imaging center) so they can deliver coordinated care.

For Payment

We use and disclose your PHI to bill and collect payment for the services we provide. If you choose to submit your visit for out-of-network insurance reimbursement, we may share information with your health plan to support that submission. If you pay for a service in full and out of pocket, you have the right under federal law (HITECH Act, 2009) to request that we not disclose the information about that service to your health plan, and we will honor that request.

For Health Care Operations

We use and disclose your PHI to support our routine business operations, including quality assessment, clinician training, credentialing, internal audits, and management. For example, we may review patient records to assess and improve our care.

Appointment Reminders and Care Communications

We may contact you by phone, text message, or email to remind you of an appointment, share post-visit instructions, or communicate about your care. You may ask us to use a specific contact method or to send communications to a specific address. We will accommodate reasonable requests.

Other Permitted or Required Disclosures

Federal law allows or requires us to disclose your PHI in certain other circumstances. These include disclosures:

• Required by federal, state, or local law.
• For public health activities, including disease prevention, FDA-regulated product safety reporting, and reporting child abuse or neglect.
• For health oversight activities, including audits, investigations, inspections, and licensure.
• For judicial and administrative proceedings, in response to a court order, subpoena, or other lawful process.
• For law enforcement purposes, as permitted by law.
• To coroners, medical examiners, and funeral directors when needed.
• For organ, eye, or tissue donation purposes.
• For approved research, with privacy protections in place.
• To avert a serious threat to health or safety.
• For specialized government functions, including military and veteran activities and national security.
• For workers' compensation as authorized by law.
• To inmates or law enforcement officials in correctional institutions, as permitted.

Uses and Disclosures That Require Your Written Authorization

Other uses and disclosures of your PHI will be made only with your written authorization. Specifically, your written authorization is required for:

• Most uses or disclosures of psychotherapy notes (where applicable).
• Uses or disclosures of your PHI for marketing purposes.
• Sale of your PHI.
• Any other use or disclosure not described in this notice or otherwise permitted by law.

You may revoke a written authorization at any time, in writing, except to the extent we have already taken action in reliance on it.

Your Rights Regarding Your Health Information

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your PHI maintained in our records, with limited exceptions. To request a copy, submit a written request to the Privacy Officer at the address below. We may charge a reasonable, cost-based fee for copies.

Right to Request an Amendment

You have the right to request an amendment to your PHI if you believe it is inaccurate or incomplete. Submit your request in writing to the Privacy Officer. We may deny a request in certain circumstances and will provide a written explanation if we do.

Right to an Accounting of Disclosures

You have the right to receive an accounting of certain disclosures of your PHI made by us, other than disclosures for treatment, payment, health care operations, or those you authorized.

Right to Request Restrictions

You have the right to request a restriction on certain uses and disclosures of your PHI. We are not required to agree to most restriction requests, but if we agree, we will honor it.

Out-of-pocket restriction (mandatory). If you pay in full and out of pocket for a service, you have an absolute right to request that we not disclose information about that service to your health plan, and we will honor that request.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your health matters in a specific way or at a specific location. For example, you may ask that we call you only at your work number or send communications to a different address. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to obtain a paper copy of this notice at any time, even if you have previously agreed to receive it electronically. Request a paper copy from the Privacy Officer or at the front desk.

Right to Be Notified of a Breach

You have the right to be notified in writing if we discover a breach of your unsecured PHI, as required by federal law.

Our Duties

Georgia Spine and Sports Rehab is required by law to:

• Maintain the privacy of your PHI.
• Provide you with this notice of our legal duties and privacy practices regarding your PHI.
• Follow the terms of the notice currently in effect.
• Notify you in writing if a breach of your unsecured PHI occurs.

Changes to This Notice

We reserve the right to change this notice at any time and to make the revised notice effective for the PHI we already have, as well as PHI we receive in the future. The current notice will always be available at the clinic and at this URL. The effective date is shown at the top of this page.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

To file a complaint with us:

Contact the Privacy Officer at the address, phone, or email below. Complaints must be submitted in writing.

To file a complaint with the federal government:

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
Web: hhs.gov/hipaa/filing-a-complaint

Contact for Privacy Matters

This Notice of Privacy Practices was issued on May 27, 2026. It supersedes any prior notice and remains in effect until amended or replaced.