NOTICE OF PRIVACY PRACTICES

Effective date: 10/7/2026

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.

This notice applies to Seven Bridges Chiropractic LLC (SBC), Dr. Dalton Tolliver, DC, and our workforce when handling your protected health information. “We,” “our,” and “us” mean SBC. It applies to information about all services you receive from our practice, including chiropractic, manual therapy, exercise services, acupuncture, and shockwave services.

Dr. Dalton Tolliver D.C., Privacy Contact
1563 Alford Pl., Ste. 5, Jacksonville, FL 32207
Phone: (904) 582-5200  |  Email: in**@***************ro.com

Who will follow this notice

Our treating physician, employees, and other workforce members follow this notice. Service providers that handle protected health information on our behalf must protect it as required by applicable law and their agreements with us.

We maintain records of your history, examinations, care, test results or reports received from other providers, communications, and payments. These records help us plan your care, communicate with treating providers, and evaluate our services.

Our responsibilities

We must protect the privacy of your protected health information, provide this notice of our legal duties and privacy practices, and follow the notice currently in effect. We must notify you following a breach of your unsecured protected health information as required by law. We use reasonable safeguards to protect your information and limit access and disclosures as required by law.

How we may use and disclose your information

The categories below describe uses and disclosures permitted or required by law. Examples do not list every circumstance. When Florida law or another applicable law provides greater protection than HIPAA, we follow that greater protection. For example, Florida law generally restricts sharing patient records outside your care team without written authorization unless a legal exception applies.

1. Treatment. We may use and share information to provide and coordinate your care. For example, we may send relevant examination findings to a practitioner involved in your treatment or a referral.
2. Payment. We may use and disclose information as legally permitted to collect payment for services. For example, we use visit and payment information to prepare your statement or resolve a billing question. Our routine practice is self-pay; this notice does not authorize or promise insurance claim submission.
3. Health care operations. We may use and disclose information as legally permitted to operate the practice, assess care quality, train staff, maintain records, and obtain professional or administrative support. For example, we may review charts to evaluate documentation and care.

Additional uses and disclosures

4. Contacting you and appointment reminders. We may contact you about appointments, billing, follow-up care, or treatment alternatives by phone, text, email, or mail, and may leave limited messages. Tell us how you prefer to be contacted. You may request confidential communications as explained below. Promotional newsletters and marketing permissions are addressed separately.
5. Electronic records and service providers. We use Jane for electronic records and administrative functions. We may share information with service providers performing authorized functions for us, subject to required privacy protections. Information may be sent electronically to treating providers or other authorized recipients.
6. People involved in your care. We may share relevant information with a person involved in your care or payment when you agree, have an opportunity to object and do not object, or when another legal basis permits it. If you cannot express a preference, we may use professional judgment where permitted. We obtain written authorization when Florida law requires it.
7. Required by law and public health. We disclose information when federal or state law requires it, including authorized compliance reviews by the U.S. Department of Health and Human Services. We may disclose information for authorized public health reporting, reports of abuse or neglect, and prevention of a serious threat to health or safety, subject to applicable legal conditions.
8. Health oversight activities. We may disclose information to legally authorized oversight agencies for activities such as investigations, inspections, licensure, and audits, only as permitted or required by law.
9. Lawsuits and law enforcement. We may disclose information in response to legal process only when the applicable requirements are met. We limit disclosures under a court order to the information authorized. A subpoena or law-enforcement request does not, by itself, permit every disclosure; required notice, authorization, protective orders, and other safeguards must be satisfied.
10. Other legally permitted disclosures. Where applicable and legally permitted, information may be disclosed for workers’ compensation, to medical examiners or coroners, for organ donation, and for authorized government functions. Each disclosure remains subject to applicable restrictions, including Florida confidentiality requirements.

Disclosures requiring written authorization

We obtain your written authorization for uses and disclosures that require it, including marketing, sales of protected health information subject to HIPAA’s authorization requirement, and most uses or disclosures of psychotherapy notes if we hold such notes. Florida law also requires a specific written release or authorization for use of patient information to solicit or market goods or services. Receipt of this notice is not that authorization.

Uses and disclosures not described in this notice require your written authorization unless otherwise permitted or required by law. You may revoke an authorization in writing by contacting our Privacy Contact. Revocation does not undo actions already taken in reliance on your authorization.

Special protection for substance use disorder records

If we receive or maintain substance use disorder patient records protected by 42 CFR Part 2, we will not use or disclose those records, or testimony describing their contents, in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a qualifying court order accompanied by a subpoena or similar legal mandate. Other Part 2 restrictions also apply. Before using such records for fundraising communications, we would provide clear notice and an opportunity to choose not to receive them.

Your rights regarding your medical information

Contact our Privacy Contact to exercise these rights or obtain help making a request. We may verify your identity or a representative’s authority before acting.

1. Right to inspect and copy. You may inspect or obtain copies of medical, billing, and other records in the designated record set used to make decisions about you. Submit your request in writing. You may request an electronic copy when available in the requested format, or another agreed readable format. We generally act within 30 days; if a lawful extension is needed, we explain the reason and completion date in writing. Any copying fee will comply with applicable federal and Florida limits. We do not withhold access because you owe us for treatment. If access is denied, we provide the required explanation and any available review rights.
2. Right to request an amendment. You may ask in writing to amend information you believe is incorrect or incomplete and explain why. We generally act within 60 days, subject to a permitted extension with written notice. We may deny an amendment if the record is accurate and complete, is outside the records subject to amendment, or was created by someone else who remains available to amend it. If we deny your request, we explain why and how you may submit a statement of disagreement.
3. Right to an accounting of disclosures. You may request an accounting of certain disclosures made during the preceding six years. The accounting excludes disclosures for treatment, payment, and health care operations and other legally excluded disclosures, such as those made under your authorization. Submit a written request identifying the time period. The first accounting in any 12-month period is free. We notify you in advance of any permitted charge for additional requests and allow you to modify or withdraw your request.
4. Right to request restrictions. You may request limits on uses or disclosures for treatment, payment, or health care operations, or on information shared with people involved in your care or payment. Specify the information, the restriction, and the persons concerned. We generally do not have to agree, but will tell you our decision. If we agree, we follow the restriction unless a legal exception applies, such as necessary emergency treatment.

We must agree to your request not to disclose information to a health plan for payment or health care operations when the information relates solely to an item or service that you, or someone other than the health plan on your behalf, paid for in full, unless disclosure is required by law.

5. Right to confidential communications. You may ask us to contact you by an alternative means or at an alternative location, such as a different phone number or mailing address. We accommodate reasonable requests. Tell us the method or location you need; you do not have to explain your reason.
6. Right to revoke an authorization. You may revoke a written authorization as described above by notifying our Privacy Contact in writing.
7. Right to a copy of this notice. You may obtain a paper copy of this notice upon request, even if you previously agreed to receive it electronically.
8. Right to a personal representative. A person legally authorized to act for you may exercise your privacy rights, subject to applicable exceptions. We verify that authority. Parents’ and guardians’ access to a minor’s information depends on applicable law and the circumstances of care.

Privacy in our office and communications

Shared areas. Treatment conversations may sometimes be overheard in our office. We use reasonable safeguards to limit incidental disclosures. You may ask to discuss sensitive information privately. Receiving care in a shared area does not waive your privacy rights.

Security cameras. Reception and waiting-room cameras record video without audio. Exterior cameras covering the entrance and parking area record video and triggered audio. Dr. Tolliver controls access to the recordings, which are retained through Ring for approximately 60 days. These security recordings are separate from clinical documentation.

Clinical documentation. We use Jane’s AI scribe to help prepare clinical documentation from session audio. Under our current settings, the audio is retained indefinitely unless deleted. Dr. Tolliver reviews clinical documentation. Recording permission and requests to pause recording are addressed in our separate AI scribe disclosure and consent. This privacy notice itself does not authorize audio recording.

Telephone recordings. Certain calls associated with our advertisements or website may be recorded through CallRail. Recording-specific notice and any legally required consent are handled separately. This notice does not replace those requirements.

Electronic communications. Ordinary email and text messages may carry privacy risks. You may request a different communication method. Our promotional newsletters are separate from appointment and care-related communications. Any use of patient information requiring a marketing authorization will occur only after the required authorization is obtained.

Questions and complaints

If you believe your privacy rights have been violated, you may file a complaint with Dr. Dalton Tolliver at the phone number, email, or mailing address below. Please describe what happened so we can investigate. We will not retaliate against you for making a complaint or exercising your privacy rights.

Dr. Dalton Tolliver, Privacy Contact
Seven Bridges Chiropractic LLC
1563 Alford Pl., Ste. 5, Jacksonville, FL 32207
(904) 582-5200  |  in**@***************ro.com

You may also complain to the U.S. Department of Health and Human Services Office for Civil Rights: 200 Independence Avenue, S.W., Washington, DC 20201; 1-877-696-6775; or https://www.hhs.gov/hipaa/filing-a-complaint/index.html.

Changes to this notice

We may change this notice and, as permitted by law, make the revised terms apply to information we already maintain and information received later. The revised notice will show its effective date and will be available in our office, on our website, and upon request.