HIPAA Notice of Privacy Practices

Effective Date: 1/1/2025

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

Your Rights

• Get an electronic or paper copy of your medical record. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
• Ask us to correct your record. You can ask us to correct health information about you that you think is incorrect or incomplete.
• Request confidential communications. You can ask us to contact you in a specific way (e.g., home or office phone) or to send mail to a different address.
• Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or operations.
• Get a list of those with whom we've shared information. You can ask for a list (accounting) of the times we've shared your health information.
• Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time.
• Choose someone to act for you. If you have given someone medical power of attorney or legal guardian, that person can exercise your rights and make choices about your health information.

How We Use and Share Your Information

We may use and share your health information to:

• Treat you. Example: A doctor treating you for an injury shares information with another doctor for consultation about your care.
• Run our organization. Example: We use health information about you to manage your treatment and services.
• Bill for your services. Example: We share information about you with your insurance company to obtain payment for services.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information for marketing purposes or sell your information without your written authorization.

Changes to This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our website, and at our office.

Contact Information

Rapha Chiropractic
6953 E 71st Street
Tulsa, OK 74311
Email: raphachirotul@gmail.com
Phone: (539) 399-2631

For more information, see hhs.gov/hipaa or return to our home page.