Notice of Privacy Practices

Effective Date: June 4, 2026 · Version: 2026-06

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.

If you have any questions about this notice, please contact our office at (347) 625-1246.

Our Obligations

We are required by law to: maintain the privacy of protected health information (PHI); give you notice of our legal duties and privacy practices regarding PHI; follow the terms of the notice currently in effect; and notify you following a breach of unsecured PHI.

We are required to notify affected individuals following a breach of their unsecured protected health information, as required by the HITECH Act and the HIPAA Breach Notification Rule.

How We May Use and Disclose Health Information

Except for the purposes described below, we will use and disclose health information only with your written permission, which you may revoke at any time by writing to our Privacy Officer.

Treatment. We may use and disclose PHI to provide and coordinate your chiropractic care, including with other providers involved in your care.

Payment. We may use and disclose PHI so that we or others may bill and receive payment from you, an insurer, or a third party for treatment and services you receive.

Health Care Operations. We may use and disclose PHI for operations such as quality assessment, training, licensing, and business management, for example to review and improve the quality of the chiropractic care our patients receive.

Appointment Reminders, Treatment Alternatives, Benefits & Services. We may use PHI to remind you of appointments and to tell you about treatment alternatives or health-related benefits and services that may interest you.

Individuals Involved in Your Care. When appropriate, we may share PHI with a family member or friend involved in your care or payment for your care.

As Required by Law / Public Health / Health Oversight / Law Enforcement / Lawsuits / Workers’ Compensation / Coroners / Organ Donation / Military / Inmates / Serious Threat to Health or Safety. We may use or disclose PHI in these special situations to the extent permitted or required by federal, state, or local law.

Marketing and Sale of PHI. Most uses and disclosures of PHI for marketing purposes, and any disclosure that is a sale of PHI, require your written authorization. Uses and disclosures of psychotherapy notes generally require your written authorization. Other uses and disclosures not described in this notice will be made only with your written authorization, which you may revoke.

Your Rights

Right to Inspect and Copy. You may inspect and copy PHI we use to make decisions about your care or payment, other than psychotherapy notes. Requests must be made in writing to our Privacy Officer.

Right to an Electronic Copy. If we maintain your PHI electronically, you have the right to obtain an electronic copy, and to direct us to transmit a copy to a person or entity you designate.

Right to Amend. You may request that we amend PHI you believe is incorrect or incomplete, in writing, to our Privacy Officer.

Right to an Accounting of Disclosures. You may request a list of certain disclosures of PHI we have made, in writing, to our Privacy Officer.

Right to Request Restrictions. You may request a restriction on the PHI we use or disclose for treatment, payment, or operations. We are not required to agree to most restriction requests.

Self-Pay Restriction (required). However, if you pay out of pocket in full for a specific item or service, you may restrict disclosure of PHI about that item or service to your health plan, and we are required to honor that request, except where disclosure is otherwise required by law.

Right to Confidential Communications. You may request that we communicate with you in a certain way or at a certain location (for example, by mail or at work). We will accommodate reasonable requests.

Right to a Paper Copy. You have the right to a paper copy of this notice at any time, even if you agreed to receive it electronically.

Changes to This Notice

We reserve the right to change this notice and to make the revised notice apply to PHI we already have as well as information we receive in the future. The current notice will be posted in our office with its effective date shown at the top.

Complaints

If you believe your privacy rights have been violated, you may file a written complaint with our Privacy Officer or with the Secretary of 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.

How to Contact Us

To exercise any of the rights described above, to request a paper copy of this notice, or to file a privacy complaint, contact:

Privacy Officer
Brooklyn Chiropractic Care, P.C.
112 Greenpoint Ave., Suite 1B
Brooklyn, NY 11222
Phone: (347) 625-1246
Fax: (347) 625-1261

Written requests may be mailed to the address above.