Pompano Beach Chiropractic Clinic
4 Northeast 4th Avenue, Pompano Beach, FL 33060
Phone: (754) 222-6642
This notice explains how we protect your medical information and your rights regarding that information. Please read it carefully.
We are committed to protecting your health information privacy. We create and maintain medical records to provide quality care and meet legal requirements. This notice describes how we may use and share your health information, as well as your rights and our responsibilities.
Questions? Contact our Privacy Officer at the number above.
We may use and share your health information for the following purposes without your written permission:
We may share your information when required by law, including:
We will NOT use or share your health information without your written authorization for:
You can revoke your authorization at any time by writing to our Privacy Officer.
You can ask us to limit how we use or share your health information. We are not required to agree to all requests, but if you pay out-of-pocket for services, we will not share that information with your insurance company unless required by law.
You can request that we contact you in a specific way or at a specific location (for example, at work instead of home, or by email instead of phone).
You can request to see or get copies of your medical records. We may charge a reasonable fee for copying costs.
If you believe information in your medical record is incorrect or incomplete, you can request that we amend it. We may deny your request if the information is accurate and complete.
You can request a list of when and why we shared your health information, with some exceptions.
You can request a paper or electronic copy of this privacy notice at any time.
You can authorize someone to make healthcare decisions for you or to receive your health information.
We may update this privacy notice at any time. The new notice will apply to all health information we maintain. We will:
If you believe your privacy rights have been violated:
Contact Us First: Privacy Officer
Pompano Beach Chiropractic Clinic
4 Northeast 4th Avenue
Pompano Beach, FL 33060
Phone: (754) 222-6642
Federal Complaint: U.S. Department of Health and Human Services
Office for Civil Rights
Email: [email protected]
Complaint form: www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaint.pdf
You will not be penalized for filing a complaint.
If there is ever a breach of your health information security, we will notify you as required by law. We may contact you by email, mail, or phone depending on the circumstances.
Effective Date: 9/17/2025
This notice is available in Spanish upon request.
We are required by law to maintain the privacy of your health information and to provide you with this notice of our legal duties and privacy practices.