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Lifeline Chiropractic provides our patient forms online for your convenience, allowing you to complete them from home or your office. Simply download the necessary forms, print them out, and fill in the required information. You can fax the completed forms, bring them to your appointment, or email them to: Lifelinechirotucson@gmail.com. Our fax number is (520) 745-8729. 

Our Cancellation And Rescheduling Policy

We value our patients and recognize that unforeseen circumstances can occur. If you need to cancel or change your appointment, it must be done 24 hours before your scheduled appointment. You can make changes by calling 520-745-8101, emailing us at LifeLineChiroTucson@gmail.com, or text us at (520) 282-4894. If there is no one to take your call, you can leave a message regarding your appointment.

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​If you completely miss an appointment and you did not call us 24 hours prior, you will be charged a $76 fee unless you have a valid reason.​

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This charge is solely the patient's responsibility and cannot be billed to insurance. The fee must be paid before other appointments are made. 

SMS Messaging Policy and HIPAA Compliance

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By providing your consent to receive SMS messages from Lifeline Chiropractic, you agree that these messages will be used solely to facilitate your care and appointments with Lifeline Chiropractic. The information collected for this service will be your mobile phone number and name.

Important HIPAA Considerations:

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  • Limited Use of PHI: While SMS messages are primarily used for appointment reminders, scheduling updates, and general information related to your care at Lifeline Chiropractic, we will make every effort to limit the inclusion of Protected Health Information (PHI) within the text message content itself. For more detailed or sensitive health information, we will direct you to a secure patient portal, a phone call, or an in-person discussion.

  • Acknowledgement of Risk: Standard SMS text messaging is not an encrypted method of communication and carries inherent risks to the privacy and security of your PHI. These risks include, but are not limited to, the possibility of interception by unauthorized third parties, messages being stored on your device and the network provider's servers, and the potential for messages to be viewed by others if your phone is lost or accessed by another individual.

  • Your Right to Withdraw Consent: You have the right to withdraw your consent to receive SMS messages at any time by replying "STOP" to any message or by contacting Lifeline Chiropractic directly.

  • Data Security and Access: Your mobile phone number and name, collected for SMS messaging, will be stored securely and accessible only to authorized staff at Lifeline Chiropractic for the purposes outlined in this policy. We employ administrative, physical, and technical safeguards to protect your information in accordance with HIPAA regulations.

  • No Third-Party Sharing of Consent: Your SMS consent will not be shared with or sold to any third parties for marketing or other unrelated purposes. Any business associates we engage in facilitating SMS messaging will be required to sign a Business Associate Agreement (BAA) to ensure they comply with HIPAA regulations regarding the protection of your PHI.

 

By providing your consent, you acknowledge and accept the risks associated with receiving SMS messages from Lifeline Chiropractic as described above.

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