Notice of Patient Privacy Policy


Notice of Patient Privacy Policy

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. We have established the appropriate safeguards to protect the privacy of your health information. Total Health Associates LLC (doing business as Hughes Family Chiropractic) will not disclose any personal information about you except as required or permitted by law. Please review it carefully.

  1. We will disclose personal information if required by state, federal, or local law. For example, if required by a court order.
  2. We may use or disclose your personal information for your treatment. For example, we may disclose information as required to another physician involved in your care.
  3. We may use and disclose your personal health information to achieve payment. For example, to achieve payment by an insurance carrier.
  4. We may use your personal information in order to support the business activities of Hughes Chiropractic. For example, we may use personal information in order to mail out postcards, newsletters.
  5. If you are a member of the armed forces, we may be required to provide information to military authorities. We can use or share information for workers’ compensation claims, law enforcement purposes.
  6. We may disclose personal health information as required if public health risk is evident. For example, suspected abuse or neglect.
  7. If you are an inmate or under custody of the law enforcement official, we may be required to release personal health information to these authorities.

Our Responsibilities:

We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have comprised the privacy or security of your information. We must follow the duties and privacy practices described in this notice. We will not share your information other than described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Your Rights:

  1. You can ask to see or get a copy of your medical record information we have about you. Ask us how to do this. We will provide a copy of your health information, usually within 30 days of your request. We may charge a reasonable cost-base fee.
  2. You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
  3. If you pay for service out of pocket in full, you can ask us not to share that information with your health insurer.
  4. You can ask us to contact you in a specific way for example, home or office phone) we will say “yes” to all reasonable request.
  5. You can choose someone to act for you (example, if you have given someone power of attorney or someone is your legal guardian.) We will make sure the person has this authority before we take any action.
  6. You can complain if you feel we have violated your rights by contacting our Privacy Office Manager (Connie Jones) at Hughes Family Chiropractic 1918 North Belt Highway St. Joseph Mo 64506 or by phone (816) 279-3319. You can also call US Health and Human Services at 1-877-696-6775 or by visiting We will not retaliate against you for filing a complaint.
  7. By signing this notice I acknowledge that I have received a copy of Total Health Associates (doing business as Hughes Family Chiropractic) Privacy Policy Notice.
  8. Some of your care may be done in an open area in front of other patients. A private room is available upon your request.

We reserve the right to change the terms of this notice.

The most current notice will be posted at the front desk in our office.

You may ask for a copy of this notice at any time.

Revised 01/02/2017

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8:00 am-5:30 pm


8:00 am-5:30 pm


8:00 am-5:30 pm


8:00 am-5:30 pm


8:00 am-5:30 pm


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