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Effective Date: April 22, 2026

Notice of Privacy Practices

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.

Chiroport LLC · 919 Maryland Ave E, Suite A · Saint Paul, MN 55106 · (651) 202-3178 · chiroportllc@gmail.com

Our Legal Duty

We are required by law to maintain the privacy and security of your protected health information (PHI), provide you with this Notice of our legal duties and privacy practices regarding your PHI, notify you following a breach of unsecured PHI, and follow the terms of the Notice currently in effect. We reserve the right to change the terms of this Notice and to make the new provisions effective for all PHI we maintain. Any updated Notice will be posted in our office, on our website at chiroportllc.com, and made available upon request.

Minnesota Health Records Act

In addition to federal HIPAA rules, Chiroport LLC complies with the Minnesota Health Records Act (Minn. Stat. §§ 144.291 to 144.298). Minnesota law is more restrictive than federal law in several areas, including requiring your written consent for many disclosures of health records that would otherwise be permitted under HIPAA for treatment, payment, or health care operations. Where Minnesota law provides greater protection of your health information, we follow Minnesota law.

How We May Use and Disclose Your Health Information

We may use and disclose your PHI for the following purposes, subject to the consent requirements of Minnesota law where applicable:

Treatment. To provide, coordinate, or manage your chiropractic care, including sharing information with other providers involved in your treatment.

Payment. To bill and collect payment for services, including submitting claims to your health insurer, auto insurer, workers’ compensation carrier, or attorney under a letter of protection.

Health Care Operations. To operate our practice, including quality improvement, staff training, licensing, audits, and business planning.

As Required by Law. When federal, state, or local law requires disclosure.

Public Health and Safety. To prevent or control disease, report suspected abuse or neglect, or address serious threats to health or safety.

Law Enforcement. In response to a valid court order, subpoena, or other legal process.

Workers’ Compensation. To the extent necessary to comply with workers’ compensation laws.

Minors. Minnesota law permits minors 12 and older to consent to certain services without parental involvement. Where that applies, we protect the minor’s records accordingly.

Uses and Disclosures That Require Your Written Authorization

The following uses and disclosures will be made only with your written authorization:

  • Most uses and disclosures of psychotherapy notes.
  • Uses and disclosures of PHI for marketing purposes.
  • Disclosures that constitute a sale of PHI.
  • Other uses and disclosures not described in this Notice.

You may revoke an authorization in writing at any time, except to the extent we have already relied on it.

Your Rights

You have the following rights regarding your PHI. To exercise any of these rights, submit a written request to the Privacy Officer at the address below.

  • Right to inspect and copy. You may inspect and obtain a copy of your PHI, in paper or electronic form, subject to limited exceptions.
  • Right to request amendment. You may request that we amend PHI you believe is incorrect or incomplete.
  • Right to an accounting of disclosures. You may request a list of certain disclosures we have made of your PHI.
  • Right to request restrictions. You may request that we limit how we use or disclose your PHI. We are not required to agree, except for disclosures to a health plan for services you paid for in full out of pocket.
  • Right to request confidential communications. You may request that we contact you in a specific way or at a specific location.
  • Right to a paper copy of this Notice. You may request a paper copy of this Notice at any time, even if you received it electronically.
  • Right to be notified of a breach. You have the right to be notified in the event of a breach of your unsecured PHI.
  • Right to file a complaint. You may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

Our Responsibilities

We will maintain the privacy and security of your PHI, notify you promptly in the event of a breach, not use or share your PHI in ways not described in this Notice without your written authorization, and inform you if we are required to share your information in a way you have asked us not to.

Privacy Officer

Dr. Jackson Lee, D.C. serves as the Privacy Officer for Chiroport LLC. All requests to exercise rights under this Notice, complaints, or questions should be submitted in writing to:

Privacy Officer — Chiroport LLC
919 Maryland Ave E, Suite A
Saint Paul, MN 55106
(651) 202-3178
chiroportllc@gmail.com

Filing a Complaint with HHS

You may file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at 200 Independence Avenue SW, Washington, DC 20201; by phone at 1-877-696-6775; or online at hhs.gov/ocr/complaints.

Changes to This Notice

We may update this Notice at any time. The updated Notice will be posted at chiroportllc.com/hipaa-notice and made available in our office. The Effective Date at the top of this Notice indicates when the current version took effect.

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