Pivot Health Inc, doing business as Auto Injury Chiropractic · Oregon City · Milwaukie · Troutdale
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.
Effective Date: October 5, 2026
This Notice applies to Pivot Health Inc, doing business as Auto Injury Chiropractic, and to all of our clinic locations in Oregon City, Milwaukie, and Troutdale, including telehealth counseling. It explains how we may use and share your protected health information (PHI) and your rights regarding that information. Every member of our workforce is required to follow this Notice.
Our Pledge Regarding Your Health Information
We are committed to protecting the privacy of your health information. We are required by law to keep your PHI private, to give you this Notice of our legal duties and privacy practices, to follow the terms of the Notice currently in effect, and to notify you if a breach affects the privacy of your unsecured PHI.
How We May Use and Share Your Information Without Your Authorization
- Treatment. We use your PHI to provide and coordinate your care. For example, your chiropractor, massage therapists, rehabilitation staff, and counselor share the information needed to treat you, and we may share information with others involved in your care, such as an imaging provider or a referring physician.
- Payment. We use and share PHI to bill and collect payment for your care. After a motor vehicle accident, this commonly includes your own auto insurer under personal injury protection (PIP), your health plan, or a workers’ compensation carrier. For example, we send your diagnosis and treatment dates with each bill, and we may give an insurer-arranged examiner the records it needs to review your claim.
- Health Care Operations. We use PHI for activities that support our practice, such as quality review, staff training, licensing, audits, and business management.
- Appointment Reminders and Care Options. We may contact you by phone, text, or mail with reminders, information about treatment alternatives, or other health-related services we offer.
- Persons Involved in Your Care. With your agreement, or as otherwise allowed by law, we may share information with a family member or friend who is involved in your care or in paying for it.
We may also use or share your information without your authorization when required or permitted by law, including for these purposes:
- As required by federal, state, or local law.
- Public health activities, and reporting of abuse, neglect, or domestic violence.
- Health oversight activities such as audits and investigations.
- Judicial and administrative proceedings, in response to a court order, or to a subpoena with the assurances the law requires.
- Law enforcement purposes permitted by law.
- Coroners, medical examiners, and funeral directors.
- Organ and tissue donation, where applicable.
- Research, when privacy safeguards required by law are in place.
- To avert a serious and imminent threat to health or safety.
- Specialized government functions, such as military or national security activities.
- Workers’ compensation, as authorized by and to the extent necessary to comply with law.
- Correctional institutions, for individuals in custody.
Uses and Disclosures That Require Your Written Authorization
Other uses and disclosures not described in this Notice will be made only with your written authorization. This includes most uses and disclosures of psychotherapy notes from our counseling services, uses and disclosures for marketing, and any sale of PHI.
Disclosures to your attorney, to another driver’s insurer or other liability insurer, or to any other third party in connection with a personal injury claim, settlement, or lien are made only with your written authorization, except where the law otherwise permits or requires the disclosure.
You may revoke a written authorization at any time, in writing, except to the extent we have already acted in reliance on it. Information disclosed under an authorization, or as this Notice permits, may be redisclosed by the person or organization that receives it and may no longer be protected by federal privacy law.
Additional Protections for Certain Information
Some information receives extra protection under Oregon and federal law, including mental health information, HIV or AIDS test information, genetic information, and records of substance use disorder treatment. Oregon law requires your specific written permission, with your initials, before we release these categories under an authorization, and we follow those requirements. If we receive substance use disorder treatment records from a program covered by 42 CFR Part 2, we will not use or disclose those records, or testimony about them, in any civil, criminal, administrative, or legislative proceeding against you unless you give written consent or a court orders it after notice to you, as federal law requires.
Your Rights Regarding Your Health Information
- Inspect and Copy. You may inspect and request a copy of your records, including an electronic copy of records we keep electronically, and you may ask us to send a copy to a person you designate in writing. We may charge a reasonable, cost-based fee.
- Amend. You may ask us to correct information you believe is incomplete or inaccurate. We may deny the request in certain cases, and we will tell you why in writing.
- Accounting of Disclosures. You may request a list of certain disclosures we have made of your information in the six years before your request.
- Request Restrictions. You may ask us to limit how we use or share your information. We are not required to agree, except that we must honor your request not to share information with your health plan about an item or service you have paid for in full, out of pocket.
- Confidential Communications. You may ask us to contact you in a specific way or at a specific location, and we will accommodate reasonable requests.
- Paper Copy. You may request a paper copy of this Notice at any time, even if you agreed to receive it electronically.
- Breach Notification. You have the right to be notified if a breach of your unsecured PHI occurs.
- Choose Someone to Act for You. If you have given someone medical power of attorney, or someone is your legal guardian, that person may exercise your rights and make choices about your information. We will confirm the person’s authority before we act.
To exercise any of these rights, contact our Privacy Officer using the information below.
Our Duties and Changes to This Notice
We are required to maintain the privacy of your PHI and to follow the terms of the Notice currently in effect. We reserve the right to change this Notice and to make the revised Notice effective for information we already have as well as information we receive in the future. We will post the current Notice in our clinics and on autoinjurychiropractic.com, and we will provide a copy on request.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services, Office for Civil Rights. You may file with the Office for Civil Rights online at ocrportal.hhs.gov, by mail to Centralized Case Management Operations, U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, or by phone at 1-877-696-6775. Complaints to the Office for Civil Rights must be filed within 180 days of when you knew of the problem. We will not retaliate against you for filing a complaint.
Contact Us
Privacy Officer: Dr. Seth Hill, DC, President
Phone: (503) 723-4462 (ask for the Privacy Officer)
Mailing Address: 1404 Molalla Ave, Oregon City, OR 97045
This Notice supersedes all prior versions. Effective October 5, 2026.
Language Assistance
ATTENTION: Free language assistance services are available to you. Appropriate auxiliary aids and services to provide information in accessible formats are also available free of charge. Call (503) 723-4462 (TTY: 711) or speak to your provider.
Español
ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. También están disponibles de forma gratuita ayuda y servicios auxiliares apropiados para proporcionar información en formatos accesibles. Llame al (503) 723-4462 (TTY: 711) o hable con su proveedor.
Việt
LƯU Ý: Nếu bạn nói tiếng Việt, chúng tôi cung cấp miễn phí các dịch vụ hỗ trợ ngôn ngữ. Các hỗ trợ dịch vụ phù hợp để cung cấp thông tin theo các định dạng dễ tiếp cận cũng được cung cấp miễn phí. Vui lòng gọi theo số (503) 723-4462 (Người khuyết tật: 711) hoặc trao đổi với người cung cấp dịch vụ của bạn.
中文
注意：如果您說中文，我們可以為您提供免費語言協助服務。也可以免費提供適當的輔助工具與服務，以無障礙格式提供資訊。請致電 (503) 723-4462（TTY：711）或與您的提供者討論。
中文
注意：如果您说中文，我们将免费为您提供语言协助服务。我们还免费提供适当的辅助工具和服务，以无障碍格式提供信息。致电 (503) 723-4462（文本电话：711）或咨询您的服务提供商。
РУССКИЙ
ВНИМАНИЕ: Если вы говорите на русском языке, вам доступны бесплатные услуги языковой поддержки. Соответствующие вспомогательные средства и услуги по предоставлению информации в доступных форматах также предоставляются бесплатно. Позвоните по телефону (503) 723-4462 (TTY: 711) или обратитесь к своему поставщику услуг.
한국어
주의: 한국어를 사용하시는 경우 무료 언어 지원 서비스를 이용하실 수 있습니다. 이용 가능한 형식으로 정보를 제공하는 적절한 보조 기구 및 서비스도 무료로 제공됩니다. (503) 723-4462(TTY: 711)번으로 전화하거나 서비스 제공업체에 문의하십시오.
العربية
تنبيه: إذا كنت تتحدث اللغة العربية، فستتوفر لك خدمات المساعدة اللغوية المجانية. كما تتوفر وسائل مساعدة وخدمات مناسبة لتوفير المعلومات بتنسيقات يمكن الوصول إليها مجانًا. اتصل على الرقم (503) 723-4462 (711) أو تحدث إلى مقدم الخدمة.
日本語
注：日本語を話される場合、無料の言語支援サービスをご利用いただけます。アクセシブル（誰もが利用できるよう配慮された）な形式で情報を提供するための適切な補助支援やサービスも無料でご利用いただけます。(503) 723-4462（TTY：711）までお電話ください。または、ご利用の事業者にご相談ください。
українська мова
УВАГА: Якщо ви розмовляєте українською мовою, вам доступні безкоштовні мовні послуги. Відповідні допоміжні засоби та послуги для надання інформації у доступних форматах також доступні безкоштовно. Зателефонуйте за номером (503) 723-4462 (TTY: 711) або зверніться до свого постачальника.
Tagalog
PAALALA: Kung nagsasalita ka ng Tagalog, magagamit mo ang mga libreng serbisyong tulong sa wika. Magagamit din nang libre ang mga naaangkop na auxiliary na tulong at serbisyo upang magbigay ng impormasyon sa mga naa-access na format. Tumawag sa (503) 723-4462 (TTY: 711) o makipag-usap sa iyong provider.
Deutsch
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlose Sprachassistenzdienste zur Verfügung. Entsprechende Hilfsmittel und Dienste zur Bereitstellung von Informationen in barrierefreien Formaten stehen ebenfalls kostenlos zur Verfügung. Rufen Sie (503) 723-4462 (TTY: 711) an oder sprechen Sie mit Ihrem Provider.
Français
ATTENTION : Si vous parlez Français, des services d'assistance linguistique gratuits sont à votre disposition. Des aides et services auxiliaires appropriés pour fournir des informations dans des formats accessibles sont également disponibles gratuitement. Appelez le (503) 723-4462 (TTY : 711) ou parlez à votre fournisseur.
हिंदी
ध्यान दें: यदि आप हिंदी बोलते हैं, तो आपके लिए निःशुल्क भाषा सहायता सेवाएं उपलब्ध होती हैं। सुलभ प्रारूपों में जानकारी प्रदान करने के लिए उपयुक्त सहायक साधन और सेवाएँ भी निःशुल्क उपलब्ध हैं। (503) 723-4462 (TTY: 711) पर कॉल करें या अपने प्रदाता से बात करें।
ភាសាខ្មែរ
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Soomaali
FIIRO GAAR AH: Haddaad ku hadasho Soomaali, adeegyo kaalmada luuqadda ah oo bilaash ah ayaad heli kartaa. Qalab caawinaad iyo adeegyo oo habboon si loogu bixiyo macluumaadka qaabab la adeegsan karo ayaa sidoo kale bilaa lacag heli karaa. Wac (503) 723-4462 (TTY: 711) ama la hadal bixiyahaaga.
فارسي
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ไทย
หมายเหตุ: หากคุณใช้ภาษา ไทย เรามีบริการความช่วยเหลือด้านภาษาฟรี นอกจากนี้ ยังมีเครื่องมือและบริการช่วยเหลือเพื่อให้ข้อมูลในรูปแบบที่เข้าถึงได้โดยไม่เสียค่าใช้จ่าย โปรดโทรติดต่อ (503) 723-4462 (TTY: 711) หรือปรึกษาผู้ให้บริการของคุณ