Privacy Policy

Jenks Family Medicine, PLLC
3908 Tennessee Avenue, Suite 110
Chattanooga, TN 37409
Phone: 423-373-5457
Website: www.jenksfamilymedicine.com

Notice of Privacy Practices
Effective Date: May 21, 2025

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.

At Jenks Family Medicine, PLLC, we are committed to protecting your private health information (PHI). We are required by law to maintain the privacy of your PHI, to provide you with this notice of our legal duties and privacy practices, and to notify you following a breach of unsecured PHI. We will follow the terms of this notice.

Your Health Information Rights

You have the following rights regarding your health information:

• Get a Copy of Your Medical Record:
  • For exams ordered by the Department of Veteran’s Affairs (VA): Jenks Family Medicine acts as a subcontractor for the VA. Due to Federal Privacy Act requirements governing these exams, we cannot directly provide you with these records. You must request these records directly from the VA.
  • For Primary Care Patients (Non-VA ordered services): You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
• Ask Us to Correct Your Medical Record: You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
• Request Confidential Communications: You can ask us to contact you in a specific way (for example, home or office 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 can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
• Get a List of Those With Whom We’ve Shared Information (Accounting of Disclosures): You can ask for a list (an accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
• Get a Copy of This Privacy Notice: You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with 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 make sure the person has this authority and can act for you before we take any action.

Your Choices About Your Health Information

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

You have the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care.
• Share information in a disaster relief situation.
• Include your information in a hospital directory (Note: This is generally applicable if you are admitted to a hospital; as a clinic, we typically do not maintain such a directory).

If you are not able to tell us your preference (for example, if you are unconscious), we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases, we never share your information unless you give us written permission:

• Marketing purposes.
• Sale of your information.
• Fundraising: Jenks Family Medicine does not engage in fundraising activities using patient information.

Our Uses and Disclosures of Your Health Information

We typically use or share your health information in the following ways:

• Treat You: We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition.
• Run Our Organization: We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services, and for quality improvement.
• Bill for Your Services: We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services.

How Else Can We Use or Share Your Health Information? (Permitted or Required by Law)

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes.

Public Health and Safety Issues:

We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do Research:

We can use or share your information for health research, subject to certain safeguards.

Comply with the Law:

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to Organ and Tissue Donation Requests:

We can share health information about you with organ procurement organizations.

Work with a Medical Examiner or Funeral Director:

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address Workers’ Compensation, Law Enforcement, and Other Government Requests:

We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official (subject to legal requirements)
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to Lawsuits and Legal Actions:

We can share health information about you in response to a court or administrative order, or in response to a subpoena (under certain conditions).

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
• We do not market or sell your personal information.

For more information on your rights and our responsibilities, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

Questions or Complaints

If you have questions about this notice or believe your privacy rights have been violated, you may contact:

You can also file a complaint with:

We will not retaliate against you for filing a complaint.