Notice of Privacy Practices

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Archetype Health and Chiropractic
Built In Inc., doing business as Archetype Health and Chiropractic
3250 Independence Drive, Suite 100, Homewood, AL 35209
Website: archetype.health

Effective date: October 27, 2026
Privacy contact: Belinda S Palmer | (205) 803-1234
Mail privacy requests or complaints to: Belinda S Palmer, at the clinic address above.

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 the health information maintained by our clinic and to our workforce when providing or supporting your care. To exercise any right below or make a complaint, call Belinda S Palmer or send a letter to her at the clinic address. We can help you submit a request and will tell you when a written request is needed.

Your rights

See or obtain your records. You may ask to inspect or receive an electronic or paper copy of your medical record and other health information we maintain about you. We will act on your request within 30 calendar days. If permitted and necessary, we may take one extension of up to 30 additional days after giving you the reason and completion date in writing within the initial period. A shorter applicable deadline takes priority. Any fee will be reasonable, cost-based, and permitted by law. If we deny access, we will explain the reason and any available review rights.

Request a correction. You may ask us to amend information you believe is incorrect or incomplete. We may deny your request, but we will explain why in writing within 60 days, unless a permitted extension applies, and explain your right to submit a statement of disagreement.

Request confidential communication. You may ask us to contact you in a particular way or at a different address or telephone number. We will accommodate reasonable requests. Contact our privacy contact to tell us your preferences.

Request limits. You may ask us to limit information used or shared for treatment, payment, or health care operations, or with people involved in your care. We generally do not have to agree, but will follow a restriction we accept, subject to applicable exceptions, including emergency treatment. If you pay in full out of pocket for an item or service and request that we not disclose it to your health plan for payment or health care operations, we will honor that request unless disclosure is required by law.

Request an accounting of disclosures. You may request a list of certain disclosures made during the six years before your request. The list generally excludes disclosures for treatment, payment, health care operations, those you authorized, and other legally excluded disclosures. One accounting in a 12-month period is free. We may charge a reasonable, cost-based fee for additional requests and will tell you the fee in advance.

Receive a paper notice. You may request a paper copy promptly at any time, even if you agreed to receive this notice electronically.

Choose a representative. A legally authorized personal representative, such as a guardian or a person with applicable health care power of attorney, may exercise your rights. We will verify that person's authority and apply any exceptions required or permitted by law.

Your choices and our uses

Choices about sharing and written authorization

You may tell us whether to share relevant information with family members, close friends, or others involved in your care or payment, or for disaster relief. When you cannot express a preference, we may share information when professional judgment indicates it is in your best interest, as permitted by law. We may also disclose information when legally permitted to lessen a serious and imminent threat to health or safety, subject to the special protections in this notice.

We will obtain your written authorization for uses or disclosures that require it, including most uses or disclosures of psychotherapy notes, marketing that requires authorization under HIPAA, and sale of protected health information. Other uses and disclosures not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time; revocation does not undo actions already taken in reliance on it.

If we contact you for fundraising, you may opt out of further fundraising communications. Your choice will not affect your treatment or payment. Before using substance use disorder records protected by 42 CFR Part 2 for fundraising, we will give you a clear, conspicuous opportunity to elect not to receive any such communications.

Common uses and disclosures

Treatment. We may use your information to provide and coordinate care and share it with other professionals treating you. For example, we may share relevant examination findings with a clinician involved in your treatment.

Payment. We may use and disclose information to bill and collect payment for care, including to a health plan when applicable. For example, billing information may identify services you received. Your rights to request restrictions are described on the previous page.

Health care operations. We may use and share information to operate the clinic, improve care, evaluate services, train staff, and manage administrative activities. For example, we may review records to assess the quality of care.

Appointments and care communication. We may contact you about appointments, your care, treatment alternatives, and health-related benefits or services as permitted by law. Tell us if you need a different method of contact. Separate communication preferences and any required permissions still apply.

Service providers. We may disclose information to business associates that perform functions for us, such as billing or records support, subject to required agreements and safeguards. We limit uses and disclosures as required by law.

Other legally permitted or required disclosures

The following disclosures are subject to the conditions and limits of applicable law; they do not give us unrestricted permission to share your records. The special protections for substance use disorder records on the next page also apply.

Public health and safety. We may share information for legally authorized disease prevention, product recalls, adverse-event reporting, reports of suspected abuse, neglect or domestic violence, and prevention or reduction of serious threats to health or safety.

Research. We may use or disclose information for health research when applicable legal requirements are satisfied, such as your authorization or an approved waiver.

Required by law and oversight. We may disclose information when required by law, including to HHS to evaluate compliance. We may disclose to health oversight agencies, including the Alabama State Board of Chiropractic Examiners, for legally authorized audits, investigations, inspections, and licensing activities, subject to applicable confidentiality limits.

Protections and responsibilities

Other government and legal purposes. Subject to legal requirements, we may disclose information for workers' compensation, law enforcement, and authorized military, national security, or other special government functions. We may respond to court or administrative orders, subpoenas, or other lawful processes only when applicable conditions are met.

Special protections for certain records

If we receive or maintain substance use disorder treatment records protected by 42 CFR Part 2, neither those records nor testimony about their contents may be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a qualifying court order. Before that court order, you or the record holder must receive notice and an opportunity to be heard as required by Part 2. The order must be accompanied by a subpoena or other legal requirement compelling disclosure. These protections apply despite general permissions elsewhere in this notice.

When we receive Part 2 records under consent for treatment, payment, or health care operations, applicable law may permit further uses and disclosures under HIPAA, subject to the Part 2 limits on proceedings against you and other applicable restrictions. Information disclosed under HIPAA may be redisclosed by a recipient and may no longer be protected by HIPAA; other applicable confidentiality laws may still protect it.

Additional Alabama protections are described under Alabama privacy protections. When an applicable law imposes stricter confidentiality limits than HIPAA, we follow those limits, including obtaining additional consent or authorization when required.

Our responsibilities

We are required by law to protect the privacy and security of your protected health information, provide you with this notice, and follow the duties and practices described in the notice currently in effect. We will notify you as required by law if a breach compromises the privacy or security of your unsecured protected health information.

We must follow this notice. Other uses and disclosures not described here require your written authorization, and we will obtain any additional consent required by applicable law. We will explain how to submit privacy requests and respond within applicable legal time limits.

Questions and complaints

You may complain directly to Belinda S Palmer by calling (205) 803-1234 or writing to her at 3250 Independence Drive, Suite 100, Homewood, AL 35209. Describe your concern and how we may reach you. You may also complain directly to HHS; you do not have to complain to us first. We will not retaliate against you or require you to waive your privacy rights to receive treatment.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

Mail: 200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775
Online: https://www.hhs.gov/hipaa/filing-a-complaint/index.html

Changes to this notice

We may change this notice, and revised terms may apply to information we already maintain as well as information we receive later. The current notice will be available upon request, in our office, and on our website at https://archetype.health. The effective date will identify the version in use.

Receiving or acknowledging this notice does not authorize additional uses or disclosures of your health information. Any authorization that is required will be requested separately.

Alabama privacy protections

These protections apply when the record or request falls within the cited law. A general permission in this notice does not override a stricter applicable confidentiality requirement.

Alabama State Board of Chiropractic Examiners

We maintain and release chiropractic records under Alabama Administrative Code r. 190-X-5-.09. You or your authorized representative may request legible, accurate copies, including for a second opinion. We may verify identity and request appropriate written documentation, but will not require a reason for your own HIPAA access request or impose an unlawful barrier to access.

We will not withhold your records because you owe an unrelated treatment bill or other clinic charge. Requests from another health care practitioner or the Board are subject to the rule's 10-working/business-day release requirement, with any required authorization or other lawful authority. Your own access request follows the HIPAA deadlines described earlier unless a shorter applicable deadline governs.

Fees, retention, and transfer

Fees for your own HIPAA access request must be reasonable and cost-based under 45 CFR 164.524(c)(4), even when Alabama permits other fees for other types of requests. We do not charge search or retrieval fees for your HIPAA access request. We explain any permitted copying, supply, or mailing fee in advance; we do not automatically apply a state per-page fee to electronically maintained records.

The Board's rule requires chiropractic records to be retained for at least five years. We retain them longer when another applicable requirement or legal hold calls for it and protect them throughout retention and disposal. When a chiropractor leaves the practice or records transfer in a practice sale, we provide the required patient notification and opportunity to arrange transfer. [Ala. Admin. Code r. 190-X-5-.09(1), (7).]

Sensitive records and representatives

Sexually transmitted diseases: Records covered by Ala. Code Section 22-11A-22 are confidential and have special restrictions on public inspection and court use. Individual records may be released with written patient consent; otherwise, we disclose them only when specifically allowed or required by applicable law.

HIV test results: Ala. Code Section 22-11A-54 restricts disclosure of protected results to persons authorized by that law or other applicable law. These paragraphs do not mean the clinic provides HIV or sexually transmitted disease testing or treatment.

Minors and other protected records: We verify a parent's, guardian's, or other representative's legal authority and follow applicable Alabama law, court orders, and HIPAA exceptions, including rules for care a minor may consent to independently. We apply any additional mental-health or other confidentiality protections that govern records we hold. Part 2 protections described earlier also apply.

Board questions or complaints

You may contact the Alabama State Board of Chiropractic Examiners about chiropractic professional conduct or a refusal to release records:

1700 Yellowleaf Road, Clanton, AL 35045
(205) 755-8000 or (800) 949-5838
chiro.alabama.gov - select the consumer Complaint Form. The Board's complaint process is separate from HHS's HIPAA complaint process. The Board has not reviewed or endorsed this notice.