At Rosemeyer Jones Chiropractic, being complaint with HIPAA guidelines is something that we take very seriously. Keeping your 'protected health information' (PHI) private is a priority of ours and a legal duty. Our full disclosure of Privacy Protection Practices can be reviewed in the HIPAA complaince binder in our front lobby waiting room. There are also copies available upon request from our from desk staff. By signing below, you are acknowledging that you understand that Rosemeyer Jones Chiropractic is complaint with HIPAA regulations and is committed to protecting the privacy of you PHI. I have reviewed the HIPAA Notice of Privacy Practices, have been provided an opportunity to discuss my right to privacy, and know that upon request I will be given a copy of the notice. Additionally, that our policies are easily available for your review.