Notice of Privacy Practices
Legg Chiropractic and Acupuncture, PLLC
13757 W Bell Rd #101, Surprise, AZ 85374
(623) 214-7600
Effective date: September 12, 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.
Our promise to you
We are required by law to protect the privacy of your health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice that is currently in effect. We are also required to notify you if a breach of your unsecured health information occurs.
How we may use and share your health information without your written permission
For treatment. We use your health information to provide your care. For example, Dr. Legg reviews your intake answers and examination findings to decide which adjustment or acupuncture treatment is appropriate, and to write your treatment plan. We may share your information with other providers who are treating you, such as your primary care doctor, an imaging center, or a specialist we refer you to.
For payment. We use and share your health information to bill and collect payment. For example, we may send your diagnosis and the services you received to your health plan, to Medicare, to an auto insurance carrier, or to a workers compensation carrier so that your visit can be paid.
For health care operations. We use your health information to run our office. This includes reviewing our own care quality, training, licensing and accreditation activities, and business management.
Appointment reminders and follow up. We may contact you by telephone, text message, email, or mail to remind you of an appointment, to check on how you are doing, or to tell you about treatment alternatives that may interest you. If you would rather we contact you a different way, tell us and we will accommodate reasonable requests.
People involved in your care. With your agreement, or when you do not object, we may share information with a family member, friend, or other person you name who is involved in your care or in payment for your care. If you are not present or are unable to agree, we will use our professional judgment and share only what is directly relevant to that person's involvement.
When required by law. We will share your health information when federal, state, or local law requires it. This includes reporting suspected abuse, neglect, or domestic violence; responding to a court order, subpoena, or lawful request from a law enforcement official; reporting to public health authorities; reporting to the Arizona Board of Chiropractic Examiners or another health oversight agency; and responding to workers compensation authorities as Arizona law allows.
Other permitted uses. We may also use or share your information for organ and tissue donation requests, with a medical examiner or funeral director, to avert a serious and imminent threat to health or safety, for specialized government functions such as military or national security activities, and for research when an institutional review board has approved a waiver of authorization.
Uses and disclosures that require your written authorization
We will ask for your written authorization before we use or share your health information for marketing purposes when we receive payment from a third party for making that communication; sell your health information; use your photograph, story, or testimonial in advertising or on our website or social media; or share psychotherapy notes, if any exist.
You may cancel a written authorization at any time by giving us your request in writing. Canceling an authorization does not affect information we already shared while the authorization was in effect. Any use or sharing of your health information that is not described in this notice will be made only with your written authorization.
Your rights
Get a copy of your record. You may ask to see or get a copy of your health and billing records. We will provide the copy, usually within thirty days of your request. We may charge a reasonable cost based fee as Arizona law allows. Under Arizona law the physical record belongs to this office, and you have the right to obtain a copy. If we keep your record electronically, you may ask for an electronic copy. We will give it to you in the electronic form and format you ask for if we can readily produce it that way, or in another electronic form we agree on with you.
Ask us to correct your record. You may ask us to amend information you believe is incorrect or incomplete. We may say no to your request, and if we do we will tell you why in writing within sixty days.
Ask for confidential communication. You may ask us to contact you in a specific way, such as only on your cell phone, 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 may 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 in full out of your own pocket, you may ask us not to send that information to your health plan, and we will say yes unless a law requires us to share it.
Get a list of those with whom we have shared information. You may ask for an accounting of disclosures we made in the six years before your request, other than disclosures for treatment, payment, and health care operations and certain other disclosures. We will provide one accounting in a twelve month period free of charge, and we may charge a reasonable cost based fee for additional requests.
Get a paper copy of this notice. You may ask for a paper copy of this notice at any time, even if you agreed to receive 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 exercise your rights and make choices about your health information. We will verify that the person has this authority before we act.
File a complaint. If you believe your privacy rights have been violated, you may file a complaint with our office or with the United States Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
How to reach us
Privacy Officer: Dr. Derek M. Legg, D.C., M.P.H.
Legg Chiropractic and Acupuncture
13757 W Bell Rd #101, Surprise, AZ 85374
(623) 214-7600
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue SW, Washington, DC 20201
1-877-696-6775
www.hhs.gov/civil-rights/filing-a-complaint/complaint-process/
Changes to this notice
We may change this notice at any time. The changed notice will apply to all health information we hold, including information created or received before the change. The current notice will always be posted in our office and on our website, and it will show the effective date.