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.

I.MOVE.Health and Performance, Inc. is committed to safeguarding the use of personal information of our patients and client (also referred to as “you” and “your”) that we obtain as your medical service provider, as described here in our Privacy Policy (“Policy”).

Our relationship with you is our most important asset. We understand that you have entrusted us with your private information, and we do everything that we can to maintain that trust. I.MOVE. Health and Performance, Inc. (also referred to as "we", "our" and "us”) protects the security and confidentiality of the personal information we have and implements controls to ensure that such information is used for proper business purposes in connection with the management or servicing of our relationship with you.

I.MOVE. Health and Performance, Inc. does not sell your non-public personal information to anyone. Nor do we provide such information to others except for discrete and reasonable business purposes in connection with the servicing and management of our relationship with you.

You may ask questions or voice any concerns, as well as obtain a copy of our current Privacy Policy by contacting Dr. Daniel Charlat D.C. in writing at I.MOVE. Health and Performance, Inc.,

1. How We Use And Disclose Your Health Information. The following section describes different ways that we use and disclose health information for treatment, payment, and health care operations. Not every use or disclosure will be noted and there may be incidental disclosure that are a byproduct of the listed uses and disclosures. The ways we use and disclose health information will fall within one of these categories:

a. For Treatment. We may use your health information to provide you with treatment or services. We may disclose your health information to staff healthcare providers and other personnel involved in your health care. Treatment includes: (i) activities performed by health care professionals providing care to you or coordinating or managing your care with third parties; (ii) consultations with and between other health care providers; and (iii) activities of non-healthcare providers or other providers covering our practice by telephone or serving as the on-call provider. For example, our healthcare provider treating you may need to know if you have other health problems that could complicate your treatment. That provider may use your medical history to decide what treatment is best for you. They may also tell another provider about your condition so that he or she can decide the best treatment for you.

b. For Payment. We may use and disclose your health information so that we may bill and collect payment from you, an insurance company, or someone else for health care services you receive from us. We may also tell your health plan about a treatment you are going to receive to obtain prior approval, or to determine whether your plan will pay for the treatment.

c. For Health Care Operations. We may use and disclose your health information in order to run our necessary administrative, educational, quality assurance and business functions. For example, we may use your health information to evaluate the performance of our staff in caring for you. We may also use health information about patients to help us decide what additional services we should offer, how we can improve efficiency, or whether certain treatments are effective. Additionally, we may give health information to healthcare providers or students for review, analysis and other teaching and learning purposes.

2. DISCLOSURES TO FAMILY AND FRIENDS. Unless you notify us in advance and in writing that you object, we may provide your health information to individuals, such as family and friends, who are involved in your care or who help pay for your care. We may do this if you tell us we can do so, or if you know we are sharing your health information with these people and you don't stop us from doing so. There may also be circumstances when we can assume, based on our professional judgment, that you would not object. For example, we may assume you agree to our disclosure of your information to your spouse if your spouse comes with you into the exam room during treatment.

Also, if you are not able to approve or object to disclosures, we may make disclosures to a particular individual (such as a family member or friend), that we feel are in your best interest and that relate to that person's involvement in your care. We may also make similar professional judgments about your best interests that allow another person to pick up such things as filled prescriptions, medical supplies and X-rays.

3. Other Permitted Uses And Disclosures Of Health Care Information.

We may use or disclose your health information without your permission in the following circumstances, subject to all applicable legal requirements and limitations:

a. Required By Law. As required by federal, state, or local law.

b. Public Health Activities. For public health reasons in order to prevent or control disease, injury or disability; or to report births, deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications, school immunizations under certain circumstances or problems with products.

c. Victims of Abuse, Neglect or Domestic Violence. To a government authority authorized by law to receive reports of abuse, neglect, or domestic violence when we reasonably believe you are the victim of abuse, neglect or domestic violence and other criteria are met.

d. Health Oversight Activities. To a health oversight agency for audits, investigations, inspections, licensing purposes, or as necessary for certain government agencies to monitor the health care system, government programs, and compliance with civil rights laws.

e. Lawsuits and Disputes. In response to a subpoena, discovery request or a court or administrative order, if certain criteria are met.

f. Law Enforcement. To a law enforcement official for law enforcement purposes as required by law; in response to a court order, subpoena, warrant, summons or similar process; for identification and location purposes if requested; to respond to a request for information on an actual or suspected crime victim; to report a crime in an emergency; to report a crime on our premises; or to report a death if the death is suspected to be the result of criminal conduct.

g. Coroners, Medical Examiners and Funeral Directors. To a coroner or medical examiner, (as necessary, for example, to identify a deceased person or determine the cause of death) or to a funeral director, as necessary to allow him/her to carryout his/ her activities.

h. Organ and Tissue Donation. To organizations that handle organ procurement or organ, eye, or tissue transplantation, or to an organ donation bank, as necessary to facilitate a donation and transplantation.

i. Research. For research purposes under certain limited circumstances. Research projects are subject to a special approval process. Therefore, we will not use or disclose your health information for research purposes until the particular research project, for which your health information may be used or disclosed, has been approved through this special approval process.

j. Serious Threat to Health or Safety; Disaster Relief. To appropriate individual(s)/organization(s) when necessary: (i) to prevent a serious threat to your health and safety or that of the public or another person; or (ii) to notify your family members or persons responsible for you in a disaster relief effort.

k. Military. To appropriate domestic or foreign military authority to assure proper execution of a military mission, if required criteria are met.

l. National Security; Intelligence Activities; Protective Service. To federal officials for intelligence, counterintelligence, and other national security activities authorized by law, including activities related to the protection of the President, other authorized persons, or foreign heads of state, or related to the conduct of special investigations.

m. Inmates. To a correctional institution (if you are an inmate) or a law enforcement official (if you are in that person's custody) as necessary: (i) to provide you with health care; (ii) to protect your or others' health and safety; or (iii) for the safety and security of the correctional institution.

n. Workers' Compensation. As necessary to comply with laws relating to workers' compensation or similar work-related injury program.

4. Disclosures Requiring Your Consent. Other than for those purposes identified above, we will not use or disclose your health information for any purpose unless you give us your specific written authorization to do so. Special circumstances that require an authorization include most uses and disclosures of your psychotherapy notes, certain disclosures of your test results for the human immunodeficiency virus or HIV, uses and disclosures of your health information for marketing purposes that encourage you to purchase a product or service, and for sale of your health information with some exceptions. If you give us authorization, you can withdraw this written authorization at any time. To withdraw your authorization, deliver or fax a written revocation to (503) . If you revoke your authorization, we will no longer use or disclose your health information as allowed by your written authorization, except to the extent that we have already relied on your authorization.

5. Your Rights Regarding Your Health Information. You have certain rights regarding your health information which we list below. In each of these cases, if you want to exercise your rights, you must do so in writing by completing a form that you can obtain by contacting Dr. Daniel Charlat DC in writing atI.MOVE. Health and Performance, Inc., 10729 SE 82nd Ave, Happy Valley, Oregon 97086. In some cases, we may charge you for the costs of providing materials to you. You can get information about how to exercise your rights and about any costs that we may charge for materials by contacting Dr. Daniel Charlat DC in writing at I.MOVE. Health and Performance, Inc., 10729 SE 82nd Ave, Happy Valley, Oregon 97086.

a. Right to Inspect and Copy. With some exceptions, you have the right to inspect and get a copy of the health information that we use to make decisions about your care. For the portion of your health record maintained in our electronic health record, you may request we provide that information to or for you in an electronic format. If you make such a request, we are required to provide that information for you electronically (unless we deny your request for other reasons). We may deny your request to inspect and/or copy in certain limited circumstances, and if we do this, you may ask that the denial be reviewed.

b. Right to Amend. You have the right to amend your health information maintained by or for us or used by us to make decisions about you. We will require that you provide a reason for the request, and we may deny your request for an amendment if the request is not properly submitted, or if it asks us to amend information that: (i) we did not create (unless the source of the information is no longer available to make the amendment); (ii) is not part of the health information that we keep; (iii) is of a type that you would not be permitted to inspect and copy; or (iv) is already accurate and complete.

c. Right to an Accounting of Disclosures. You have the right to request a list and description of certain disclosures by us of your health information.

d. Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you: (i) for treatment, payment, or healthcare operations; (ii) to someone who is involved in your care or the payment for it, such as a family member or friend; or (iii) to a health plan for payment or health care operations purposes when the item or service for which we have been paid out of pocket in full by you or someone on your behalf (other than the health plan). Except for the request noted in (iii) in this Section 5.4, we are not required to agree to your request. Any time we agree to such a restriction, it must be in writing and signed by our Privacy Officer or his or her designee.

e. Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain place. We will accommodate reasonable requests. For example, you can ask that we only contact you at work or by mail.

f. Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice,

whether or not you may have previously agreed to receive the Notice electronically.

g. Right to be Notified of a Breach. You have the right to be notified if there is a breach – a compromise to the security or privacy of your health information – due to your health information being unsecured. We are required to notify you within sixty (60) days of discovery of a breach.

6. REVISIONS TO THIS NOTICE. We have the right to change this Notice and to make the revised or changed Notice effective for health information we already have about you, as well as any information we receive in the future. Except when required by law, a material change to any term of the Notice may not be implemented prior to the effective date of the Notice in which the material change is reflected. We will post the revised Notice at our office and on our website and provide you with a copy of the revised notice upon your request.

7. QUESTIONS OR COMPLAINTS. If you have any questions about this Notice, please contact us by contacting Dr. Daniel Charlat DC in writing at: I.MOVE. Health and Performance, Inc., 10729 SE 82 nd Ave., Happy Valley, Oregon 97086. If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. In order to file a complaint with us, please contact Dr. Daniel Charlat DC in writing at I.MOVE. Health and Performance, Inc., 10729 SE 82nd Ave, Happy Valley, Oregon 97086. You will not be penalized or retaliated against for filing a complaint.

I.MOVE.HEALTH AND PERFORMANCE IS COMMITTED TO PROVIDING INCLUSIVE PATIENT CARE.

I.MOVE. Health and Performance, Inc. complies with applicable state and federal civil rights laws and does not discriminate, exclude people or treat them differently on the basis of:

- Race

- Color

- National origin

- Age

- Disability; or

- Sex.

LANGUAGE SERVICES NOTIFICATION: TRANSLATIONS FOR MOST-SPOKEN LANGUAGES IN OREGON.

Language assistance services (in person, live over the phone or live video) are available to you free of charge upon request. Please let us know if you need language services for your visit.

WE ARE HERE TO HELP YOU WITH YOUR CONCERNS.

If you believe that we have failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file a grievance in writing with us by contacting Dr. Daniel Charlat DC in writing at I.MOVE. Health and Performance, Inc., .

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue SW., Room 509F, HHH Building Washington, D.C. 20201, 800-868-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.