Privacy Policy & Notice of Privacy Practices
Last updated: [Month Year]. This page explains what information we collect through this website, how it's used, and your rights regarding your health information under HIPAA.
Information we collect on this website
When you use the contact form on this site, we collect the information you choose to provide: your name, email address, phone number, and the general reason for your visit. We do not knowingly collect detailed medical history, diagnoses, or treatment information through this website — please call our office directly for anything related to your health.
Like most websites, our server and hosting provider may automatically log basic technical information (such as browser type and IP address) for security purposes.
How we use your information
- To respond to your message or scheduling request.
- To contact you about an upcoming or requested appointment.
- We do not sell or rent your information to third parties.
Notice of Privacy Practices (HIPAA)
[This section should describe, in plain language, how your practice uses and discloses Protected Health Information (PHI) for treatment, payment, and healthcare operations; patients' rights to access, amend, and request restrictions on their records; how to file a complaint; and your designated Privacy Officer's contact information. A model Notice of Privacy Practices is available from the U.S. Department of Health and Human Services (HHS) and should be adapted with legal guidance for your practice.]
Third-party services
This website may use third-party services for functions like appointment booking (e.g., JaneApp) or form handling. Any such service that could receive patient health information should have a signed Business Associate Agreement (BAA) with our practice, as required by HIPAA. Services that will not sign a BAA are not used for anything beyond general, non-health-related scheduling questions.
Your rights
You have the right to request access to, and copies of, your medical records; request corrections; request a list of certain disclosures; and file a complaint if you believe your privacy rights have been violated, without fear of retaliation. [Add your practice's specific process for exercising these rights.]
Contact us about this policy
If you have questions about this policy or your privacy rights, contact us at (562) 381-0378 or info@solomonchiropractic.example, or write to us at 7320 Firestone Blvd #115, Downey, CA 90241.