Notice of Privacy Practices

Our Commitment to Your Privacy

LeGault Chiropractic, PC (“we,” “us,” or “our”) is required by law to maintain the privacy of your protected health information (“PHI”), to give you this Notice of our legal duties and privacy practices with respect to your PHI, to notify you following a breach of unsecured PHI, and to follow the terms of the Notice currently in effect. PHI is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health, the health care you receive, or payment for that care. This Notice applies to all records of your care generated by this practice.

1. How We May Use and Disclose Your Health Information Without Your Authorization

Treatment

We use and disclose your PHI to provide, coordinate, and manage your chiropractic care. For example, we may send your examination findings and x-ray results to a physician, physical therapist, or specialist to whom we refer you.

Payment

We use and disclose your PHI to obtain payment for the services we provide. For example, we may submit a claim containing your diagnosis and dates of treatment to your health plan, or contact your plan to verify coverage or obtain prior authorization.

Health Care Operations

We use and disclose your PHI to support the business activities of this practice. For example, we may review your records to assess the quality of care we provide, to train or evaluate staff and students, or to support licensing, credentialing, and accreditation.

Business Associates

We may disclose your PHI to outside companies that perform services for us, such as billing companies, our electronic health record vendor, and professional advisors. We require each of them to protect your PHI under a written business associate agreement.

Family, Friends, and Others Involved in Your Care

Unless you object, we may share PHI relevant to their involvement with a family member, friend, or other person you identify who is involved in your care or in payment for your care, and we may share PHI with a disaster relief organization so that your family can be notified of your location and condition. If you are deceased, we may share relevant PHI with family members and others who were involved in your care before your death, unless doing so is inconsistent with a preference you previously expressed. We may also disclose your PHI to a personal representative who has legal authority to act on your behalf, such as a parent or legal guardian.

Appointment Reminders and Treatment Alternatives

We may contact you to remind you of an appointment, or to tell you about treatment options or health-related benefits and services that may be of interest to you.

Other Uses and Disclosures Permitted or Required by Law

Subject to the conditions and limits set by law, we may use or disclose your PHI without your authorization:

• As required by federal, state, or local law.
• For public health activities, such as reporting disease, injury, or vital events, and reporting problems with FDA-regulated products.
• To report suspected abuse, neglect, or domestic violence to a government authority authorized by law to receive such reports.
• For health oversight activities, including audits, investigations, inspections, and licensure actions.
• In judicial and administrative proceedings, in response to a court or administrative order, or to a subpoena or discovery request when the assurances required by law have been given.
• For specified law enforcement purposes, such as responding to a court order or warrant, identifying or locating a suspect or missing person, or reporting a crime on our premises.
• To coroners, medical examiners, and funeral directors, as necessary for them to carry out their duties.
• To organ procurement organizations for cadaveric organ, eye, or tissue donation.
• For research, when an institutional review board or privacy board has approved a waiver of authorization, or under other limited circumstances permitted by law.
• To avert a serious and imminent threat to the health or safety of you or another person.
• For specialized government functions, including military and veterans activities, national security and intelligence, protective services for the President, and the care of inmates in correctional institutions.
• For workers’ compensation, to the extent authorized by and necessary to comply with workers’ compensation laws.

2. Uses and Disclosures That Require Your Written Authorization

Uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. In particular, your written authorization is required for:

• Most uses and disclosures of psychotherapy notes;
• Uses and disclosures of PHI for marketing purposes; and
• Disclosures that constitute a sale of your PHI.

You may revoke a written authorization at any time by submitting a written revocation to our Privacy Officer. A revocation will not apply to any use or disclosure we already made while relying on your authorization.

3. Substance Use Disorder Records and Other More Protective Laws

Some information is given greater protection than HIPAA requires. Where another federal or state law is more restrictive than HIPAA, we follow the more restrictive law. This includes, among others, substance use disorder (SUD) treatment records protected by 42 CFR Part 2, and categories of information given added protection under Pennsylvania law, such as HIV-related information and mental health records. If we create or maintain SUD treatment records received from a program subject to 42 CFR Part 2, we generally may not use or disclose those records for treatment, payment, or health care operations without your written consent, even though HIPAA alone would permit it.

Substance use disorder treatment records received from programs subject to 42 CFR Part 2, or testimony relaying the content of such records, shall not be used or disclosed in civil, criminal, administrative, or legislative proceedings against the individual unless based on written consent, or a court order after notice and an opportunity to be heard is provided to the individual or the holder of the record, as provided in 42 CFR Part 2. A court order authorizing use or disclosure must be accompanied by a subpoena or other legal requirement compelling disclosure before the requested record is used or disclosed.

4. Redisclosure

Information disclosed under this Notice may be redisclosed by the person or organization that receives it and may then no longer be protected by the HIPAA Privacy Rule.

5. Fundraising and Marketing

We do not use or disclose your PHI to raise funds for this practice, and we do not use or disclose your PHI for marketing purposes without your written authorization.

6. Your Rights Regarding Your Health Information

You have the rights described below. To exercise any of them, please submit a written request to our Privacy Officer at the address at the end of this Notice.

• Right to request restrictions. You may ask us to limit how we use or disclose your PHI for treatment, payment, or health care operations, or what we share with people involved in your care. We are not required to agree, except in one case: we must agree to a request to restrict disclosure to a health plan for payment or health care operations if you have paid for the item or service in full, out of pocket, and the disclosure is not otherwise required by law.
• Right to confidential communications. You may ask us to contact you by a particular means or at a particular location. We will accommodate reasonable requests.
• Right to inspect and copy. You may inspect and obtain a copy of your medical and billing records, including an electronic copy if we maintain the records electronically. We may charge a reasonable, cost-based fee. In limited circumstances we may deny a request; some denials are subject to review.
• Right to amend. You may ask us to correct information you believe is inaccurate or incomplete. If we deny your request, you may submit a statement of disagreement to be included in your record.
• Right to an accounting of disclosures. You may request a list of certain disclosures we made of your PHI, generally covering up to six years. The list does not include disclosures for treatment, payment, health care operations, and certain other purposes. One accounting in any twelve-month period is free.
• Right to a paper copy of this Notice. You may request a paper copy at any time, even if you agreed to receive the Notice electronically.
• Right to notification of a breach. You will be notified if there is a breach of your unsecured PHI.
• Right to choose someone to act for you. If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your PHI. We will verify that the person has this authority before we act.

7. Our Legal Duties

We are required by law to maintain the privacy of your PHI, to give you this Notice of our legal duties and privacy practices, to notify you following a breach of unsecured PHI, and to abide by the terms of the Notice currently in effect. We reserve the right to change this Notice, and to make the revised Notice effective for all PHI we maintain, including information we created or received before the change. If we make a material change, we will post the revised Notice in our office, make copies available on request, and post it on our website if we maintain one. You may obtain the current Notice at any time.

8. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us, send a written complaint to our Privacy Officer at the address below, or call our office. We will not retaliate against you for filing a complaint, and filing a complaint will not affect your treatment or benefits.

By mail

Office for Civil Rights, Centralized Case Management Operations, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F, HHH Building, Washington, D.C. 20201

Regional

Office for Civil Rights, 801 Market Street, Suite 9300, Philadelphia, PA 19107-3134

By phone

1-800-368-1019 (TDD: 1-800-537-7697)

Online

ocrportal.hhs.gov

9. Contact Information

If you have questions about this Notice, or would like more information about our privacy practices, please contact our Privacy Officer:

Privacy Officer

Steven K. LeGault, DC

Phone

412-364-4100

Address

LeGault Chiropractic, PC, 120 Three Degree Rd, Pittsburgh, PA 15237

Effective Date

August 17, 2026