Draft for legal review. This Notice of Privacy Practices is a working draft prepared to satisfy HIPAA's required content. It must be reviewed and finalized with your healthcare-privacy attorney, and the bracketed items (Privacy Officer, effective date, contact details) completed, before it is posted or distributed to patients.

Notice of Privacy Practices

Effective date: August 15, 2026

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.

Wichman Orthopedics and Wellness, the trade name of Wisconsin Center for Orthopedics and Wellness, S.C. ("we," "us," or "our"), is required by law to maintain the privacy of your protected health information (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 are required to abide by the terms of the Notice currently in effect.

How we may use and disclose your health information

The following describes the ways we may use and disclose your PHI. Not every use or disclosure will be listed, but all of the ways we are permitted to use and disclose information fall within one of these categories.

Treatment

We may use your PHI to provide, coordinate, or manage your medical care and related services. For example, we may share information with physical therapists, imaging centers, surgical facilities, referring physicians, or other providers involved in your care.

Payment

We may use and disclose your PHI to obtain payment for the services we provide, such as billing your insurer, verifying coverage and benefits, obtaining prior authorization, and, for out-of-network care, negotiating or arbitrating claims on your behalf.

Health care operations

We may use and disclose your PHI to run our practice, improve care quality, train staff, and conduct business management and administrative activities.

Appointment reminders and care communications

We may contact you to provide appointment reminders, confirmations, results, and care-related follow-up, including by phone, text message (if you have opted in), email, or mail. See our SMS Terms and Privacy Policy for how text messaging works.

Uses and disclosures that may be made without your authorization

We may use or disclose your PHI without your authorization in the following circumstances, subject to the limits set by law:

When required by federal, state, or local law
For public health activities, such as reporting disease, injury, or vital events, and for FDA-regulated product safety
To report suspected abuse, neglect, or domestic violence
For health oversight activities such as audits and investigations
In response to a court or administrative order, subpoena, or other lawful process
For law enforcement purposes as permitted by law
To coroners, medical examiners, and funeral directors as necessary
For organ, eye, or tissue donation
For certain research purposes with required approvals and safeguards
To avert a serious and imminent threat to health or safety
For specialized government functions, such as military and veterans' activities and national security
For workers' compensation as authorized by law

Uses and disclosures that require your written authorization

Other uses and disclosures not described in this Notice will be made only with your written authorization. In particular, most uses and disclosures for marketing purposes, disclosures that constitute a sale of PHI, and uses and disclosures of psychotherapy notes (if any) require your authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

Your rights regarding your health information

Access. You have the right to inspect and obtain a copy of your PHI, including an electronic copy of electronic records, subject to limited exceptions. We may charge a reasonable cost-based fee.
Amendment. You may request that we amend PHI you believe is incorrect or incomplete. We may deny the request in certain circumstances and will explain why in writing.
Accounting of disclosures. You may request a list of certain disclosures we made of your PHI.
Restrictions. You may request restrictions on certain uses and disclosures. We are not required to agree, except that we must agree to a request to restrict disclosure to a health plan for a service you paid for in full out of pocket.
Confidential communications. You may request that we communicate with you in a certain way or at a certain location, and we will accommodate reasonable requests.
Paper copy. You have the right to a paper copy of this Notice, even if you agreed to receive it electronically.
Breach notification. You have the right to be notified following a breach of your unsecured PHI.

Our duties

We are required by law to maintain the privacy and security of your PHI, to provide you this Notice of our legal duties and privacy practices, to notify you if a breach of your unsecured PHI occurs, and to follow the terms of the Notice currently in effect. We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have as well as information we receive in the future. If we make a material change, we will post the revised Notice in our office and on this website and make paper copies available upon request.

How to file a complaint

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

Office for Civil Rights, U.S. Department of Health and Human Services. Complaints may be filed at hhs.gov/ocr.

Contact us

To exercise any of your rights, ask questions, or file a complaint, contact our Privacy Officer:

[ Privacy Officer name / title ]
Wichman Orthopedics and Wellness, Milwaukee, Wisconsin
Email: [email protected]