Synergy Health

8191 Birchwood Court, Unit C
Johnston, IA 50131

Privacy Officer:
Brock Vosberg, D.C.
Phone: (515) 276-8326
Effective Date: October 1, 2025

Notice of Privacy Practices

This notice describes how your medical information may be used and disclosed, and how you can access this information. Please review it carefully.

At Synergy Health, we understand the importance of patient privacy and are committed to protecting your medical information. This notice describes how we may use and disclose your health information, your rights, and our legal obligations regarding your protected health information (PHI). If you have any questions, please contact our Privacy Officer listed above.

Table of Contents

  • A. How We May Use or Disclose Your Health Information

  • B. When We May Not Use or Disclose Your Information

  • C. Your Health Information Rights

  • D. Changes to This Notice

  • E. How to File a Complaint

A. How We May Use or Disclose Your Health Information

We may use or disclose your PHI without your written authorization for the following purposes:

1. Treatment

To provide, coordinate, or manage your health care. This includes sharing information with other providers involved in your care, such as specialists, labs, or pharmacies.

2. Payment

To obtain reimbursement for services provided. Information may be shared with your health plan or others involved in billing and payment.

3. Health Care Operations

To support our practice operations, including quality improvement, staff training, licensing, audits, compliance reviews, and accreditation activities. We may also share information with "business associates" (e.g., billing companies), who are legally required to safeguard your information.

4. Appointment Reminders & Communications

We may contact you to remind you of appointments or provide information about treatment alternatives or health-related services.

5. Family & Friends Involved in Your Care

We may disclose information to a family member, friend, or caregiver involved in your care, unless you object. In emergencies or if you are incapacitated, we will use our best judgment.

6. Organized Health Care Arrangements (OHCAs)

We may participate in joint healthcare operations with other providers or entities for your benefit. A list of OHCAs we participate in is available from our Privacy Officer.

7. Marketing

We may contact you with communications about health-related products or services, provided we do not receive payment for doing so. Any use of your information for paid marketing purposes requires your written authorization.

8. Sale of PHI

We will not sell your health information without your written authorization.

9. Public Health & Safety

We may disclose information as required by law for:

  • Disease prevention and control

  • Reporting abuse or neglect

  • FDA reporting

  • Public health investigations

  • Preventing or reducing serious health threats

10. Legal Requirements

We may disclose your information in compliance with:

  • Judicial or administrative orders

  • Health oversight agencies (e.g., audits, inspections)

  • Law enforcement requests within legal limits

  • Subpoenas, provided notification requirements are met

11. Coroners, Organ Donation & Military

We may share PHI with coroners, funeral directors, and organ donation organizations as needed. Disclosures may also occur for military, national security, or correctional institution purposes.

12. Workers’ Compensation

Your health information may be used or disclosed for workers' compensation and employer workplace injury reporting purposes.

13. Proof of Immunization

We may disclose immunization records to schools upon receipt of your verbal or written authorization.

14. Breach Notification

If a breach of unsecured PHI occurs, we will notify you as required by law. If you have provided an email address, we may use it for communication related to the breach.

15. Change of Ownership

If Synergy Health merges with or is acquired by another organization, your medical information will become the property of the new entity but will remain protected under applicable laws.

B. When We May Not Use or Disclose Your Information

We will not use or disclose your health information for any reason not described in this notice unless you provide written authorization. You may revoke your authorization at any time in writing.

C. Your Health Information Rights

1. Request Restrictions

You may request limitations on how we use or share your information. We are not required to agree, except in cases where you pay out-of-pocket in full and request that we not share information with your insurer.

2. Request Confidential Communications

You can ask to be contacted in specific ways (e.g., at work or via a specific phone number). We will accommodate reasonable requests.

3. Right to Access & Copy Records

You may inspect or request a copy of your health records. Requests must be made in writing and specify the desired format. We may charge a reasonable fee for labor, materials, and postage. In limited cases, we may deny the request, in which case you may appeal.

4. Right to Amend Records

If you believe your record is incorrect or incomplete, you may request an amendment in writing. We may deny the request but will notify you of our decision and provide a right to respond.

5. Right to an Accounting of Disclosures

You may request a list of certain disclosures made outside of treatment, payment, or healthcare operations for up to six years. Exceptions apply for disclosures made with your authorization or for purposes legally exempt from accounting.

6. Receive a Paper or Electronic Copy of this Notice

You can request a physical or electronic copy of this notice at any time, even if you received it electronically initially.

To exercise any of these rights, please contact our Privacy Officer listed above.

D. Changes to This Privacy Policy

We reserve the right to modify this notice at any time. Revised notices will apply to all existing records and will be made available in our office and on our website.

E. Complaints

If you believe your privacy rights have been violated or how your information has been handled, you may file a complaint with:

Synergy Health Privacy Officer (contact information listed at top),
or directly with the U.S. Department of Health and Human Services:
Email: OCRMail@hhs.gov
Form: HIPAA Complaint Form PDF

You will not be penalized or retaliated against for filing a complaint.