Notice of privacy practices.

Your rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get a copy of your health and claims records

• You can ask to see or get a paper or electronic copy of your health record and other health information we have about you. Ask us how to do this.
• We will give you a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your health record

• You can ask us to correct health information about you that you think is wrong or incomplete. Ask us how to do this.
• We may say "no" to your request, but we will tell you why in writing within 60 days.

Ask for confidential communications

• You can ask us to contact you in a specific way (for example, your cell phone instead of your home phone, or email instead of a call) or to send mail to a different address.
• We will say "yes" to all reasonable requests.

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment, payment or our operations. We are not required to agree, and we may say "no" if it would affect your care.
• If you pay for a service or health care item out of pocket in full, you can ask us not to share that information with your health insurer for payment or our operations. We will say "yes" unless a law requires us to share it.

Get a list of those we've shared information with

• You can ask for a list (an accounting) of the times we've shared your health information for up to six years before the date you ask, who we shared it with, and why.
• We will include all the disclosures except those for treatment, payment and health care operations, and certain other disclosures (such as any you asked us to make). We will give you one accounting a year for free, but we will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this notice

• You can ask for a paper copy of this notice at any time, even if you agreed to get it electronically. We will give you a paper copy promptly.

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 use your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

• You can complain if you feel we have violated your rights by contacting us using the information under "Contact us" below.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/hipaa/filing-a-complaint.
• We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations below, talk to us. Tell us what you want us to do, and we will follow your instructions.

You can tell us whether we may:

• Share information with your family, close friends or others involved in your care
• Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

We never share your information for these purposes unless you give us written permission:

• Marketing
• Sale of your information
• Most sharing of psychotherapy notes (our office does not keep psychotherapy notes)

Fundraising

Our office does not do fundraising. If we ever contact you to raise funds, you can tell us not to contact you again, and we will honor that.

Our uses and disclosures

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you. For example, Dr. Cain may send your X-ray findings to your medical doctor, or talk with a physical therapist who is also treating you.

Run our practice

We can use and share your health information to run our practice, improve your care and contact you when necessary. For example, we use your health information to schedule visits, send appointment reminders and review the quality of our care.

Bill for your services

We can use and share your health information to bill and get payment from health plans or others. For example, we give you a receipt with the visit codes (a superbill) so you can file with your health plan yourself. For Medicare patients, we send Medicare the claim for the visit.

Companies that work for us

Some services are done for us by other companies, such as our scheduling and health record software, email and file storage, and billing help. We may share your information with them so they can do that work. Each one must sign a written agreement to protect your information the way the law requires.

Texts, email and reminders

If you give us a cell phone number or email address, we may use it to send appointment reminders and other messages about your care, or to tell you about treatment options and health services we offer. Regular email and text messages are not fully secure. If you would rather we contact you another way, tell us and we will.

Our website's Posture Screening

Our website offers a free Posture Screening. When you finish it, your name and contact information come to our office so we can follow up. Your photos, answers and results come to us only if you choose to send them. If you do, we keep and protect them like the rest of your health information. Photos of children under 19 are never sent to our office.

Other ways we may use or share your information

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.

Help with public health and safety issues

• Preventing disease
• Helping with product recalls
• Reporting bad reactions to medicines or products
• Reporting suspected abuse, neglect or domestic violence
• Preventing or reducing a serious threat to anyone's health or safety

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner or funeral director when a person dies.

Address workers' compensation, law enforcement and other government requests

• For workers' compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions, such as military, national security and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Substance use disorder treatment records

If we receive records about you from a substance use disorder treatment program covered by federal law (42 CFR Part 2), we will not use or share those records, or testimony about what is in them, in any civil, criminal, administrative or legislative proceeding against you unless you give written consent, or a court orders it after you have been given notice and a chance to be heard. A court order to use or share these records must come with a subpoena or other legal requirement that compels the disclosure.

Information that leaves our office

When we share your information as this notice allows, the person or organization that receives it may share it again, and it may then no longer be protected by federal privacy law.

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 compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as 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.
• When Nebraska law gives your information more protection than federal law, we follow the stricter law.

For more information, see HHS's guide to privacy notices.

Children and teens

In Nebraska, a person under 19 is a minor unless they are married. A parent or legal guardian usually acts for a minor and can use the rights in this notice on the minor's behalf. When state or federal law lets a minor make a health care decision on their own, the minor controls the information about that care.

Changes to this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office and on our website.

Contact us

To use any of the rights in this notice, to ask a question, or to file a complaint with our office, contact our Privacy Officer:

Dr. James Cain, D.C., Privacy Officer
Champion Family Chiropractic
2935 Pine Lake Road, Suite C, Lincoln, NE 68516
Phone: 402-423-4422
Email: office@championchirolincoln.com

This notice takes effect November 1, 2026 and replaces any earlier notice from our office.