The Privacy Rule establishes a set of national standards for the protection of certain health information.  The Privacy Rule was issued to implement the requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  The Privacy Rule standards address the use and disclosure of individuals' health information - called "protected health information" by organizations subject to the Privacy Rule - called "covered entities", as well as standards for individuals' privacy rights to understand and control how their health information is used.

For more information on your rights as a consumer, click here.

Read Freeley Chiropractic's Notice of Privacy Practices.

Office Forms

Choose the appropriate form below based on your current symptoms.  If you have both neck and low back symptoms, please print and fill out both forms.

To download these forms, you must have Adobe Reader installed on your computer.  You will be redirected to the Adobe Reader download page.  Follow the instructions for download and then return to this page.