Notice of Privacy Practices
Effective July 2026
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.
Athletic & Family Chiropractic, PL (also DBA Wellness Sport & Spine) is required by law to maintain the privacy of your protected health information (PHI), to provide you with this notice describing our legal duties and privacy practices, and to abide by the terms of the notice currently in effect.
Our Website Contact Form Is Not a Secure Channel for PHI
The contact form on our Contact Us page is meant for general inquiries and scheduling requests, not for sending protected health information. Please don't describe your symptoms, diagnosis, or treatment in that form — call our office at 850-385-5113 instead for anything related to your health or care. See our Privacy Policy for how that form's data is handled.
How We May Use and Disclose Your Health Information
We use and disclose health information about you for treatment, payment, and health care operations. For example:
- Treatment — sharing information with other providers involved in your care, such as a referring physician or a specialist you're co-managed with.
- Payment — providing information to your insurance plan (such as Capital Health Plan, Medicare, or your auto/workers' compensation carrier) so that claims can be processed and paid.
- Health Care Operations — using information internally for quality review, staff training, and normal business operations of the practice.
We may also use or disclose your information, without your written authorization, as required or permitted by law — for example: as required by law enforcement or court order, for public health activities, to avert a serious threat to health or safety, or in connection with a workers' compensation claim. Any other use or disclosure of your health information will only be made with your written authorization, which you may revoke at any time.
Your Rights Regarding Your Health Information
- Right to Inspect and Copy — you may request to inspect and receive a copy of your health records.
- Right to Request Amendment — you may ask us to amend your health information if you believe it is incorrect or incomplete.
- Right to an Accounting of Disclosures — you may request a list of certain disclosures we've made of your health information.
- Right to Request Restrictions — you may ask us to limit how we use or disclose your information; we are not required to agree, except in certain cases involving disclosures to a health plan for services you paid for out of pocket in full.
- Right to Request Confidential Communications — you may ask us to contact you in a specific way (for example, at a different phone number) or at a different location.
- Right to a Paper Copy of This Notice — you may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
- Right to File a Complaint — if you believe your privacy rights have been violated, you may file a complaint with our office 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 are required by law to maintain the privacy of your health information, provide you with this notice of our legal duties and privacy practices, 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 revised notice effective for all health information we maintain. Any revised notice will be available at our office and posted here.
Questions or Complaints
If you have questions about this notice or wish to exercise any of the rights described above, contact our Privacy Officer by phone at 850-385-5113, by fax at 850-385-5601, or by mail at 2309 Wednesday St, Tallahassee, FL 32308.
You can also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, 1–800–868–1019, 800–537–7697 (TDD).