Our policies

Financial Policy and Card on File

Payment at the time of care. Payment is due at the time of each visit unless you are on a care plan with a payment schedule (see your Care Plan Agreement). We do not bill insurance. Billing patients directly keeps our fees low. On request, we give you a statement with the codes your insurance needs; if your plan reimburses you, the payment goes directly to you.

Ways to pay. Cash, check, credit or debit card, or a care plan payment schedule.

Card on file. We keep a card on file through our payment processor, Stripe. We never see or store your full card number. By signing, you authorize Lazar Upper Cervical to charge this card for:

• care plan payments on the schedule you agree to;
• balances for care you received;
• missed-visit and returned-payment fees under this policy;
• products you order.

You'll receive a receipt for every charge. You may update or remove your card at any time; if you remove it, we'll arrange another way to make scheduled payments.

Missed visits. Please give at least 2 business days' notice to cancel or reschedule. A visit missed without notice may be charged a $137 missed-visit fee or forfeited from your plan. Text reminders are a courtesy and are not guaranteed; you are responsible for knowing your schedule.

Returned payments. A $37 fee is charged for declined or returned payments.

Care plans. Refunds when ending care early, and the stop-care fee, are covered in your Care Plan Agreement.

Responsible party. If the patient is a minor, the parent or guardian who signs is responsible for payment.

Electronic Communications

We may communicate with you by:

• Text
• Email
• Patient portal
• Video visits

Electronic communication carries some security risk. You may opt in or opt out at any time. Phone calls may be recorded for documentation and quality purposes.

Consent to Care and Terms of Acceptance

Our objective. When you ask us for care and we accept you as a patient, we both need to be working toward the same goal. Lazar Upper Cervical practices QSM3 (Quantum Spinal Mechanics), an upper cervical specialty. We use the upper neck as the lever to correct the posture and framework of the whole body. Our objective is to find and correct structural shifts that interfere with how your nervous system works, so your body can express its full health potential.

What we do.

• Examination: your history, a posture and neurological evaluation, and other non-invasive tests as needed, such as posture analysis and nerve scans.
• Imaging: precise X-rays of the upper neck, and of other areas as needed, to measure your structure and plan your correction (see the X-ray Consent).
• Correction: a precise, low-force correction to the upper neck, based on your X-rays and measurements. No cracking, no twisting.
• Progress checks: re-examinations and follow-up imaging to measure change.

What we don't do. We do not diagnose or provide care for any disease or condition other than the structural shifts described above. If an examination shows something outside our scope, we will tell you and recommend a provider who specializes in that area. We do not give advice about care prescribed by your other providers; continue that care unless they advise otherwise.

Results. Many patients notice improvement, but results vary from person to person and no specific result is guaranteed.

Possible effects and risks. Upper cervical correction is low-force, and serious complications are rare. For a day or two after a correction you may notice soreness or stiffness in the neck or back, a mild headache, or tiredness as your posture changes. Tell us right away about anything unusual. Very rare complications reported with chiropractic care of the neck in general include disc injury, fracture, and injury to an artery in the neck that may be associated with stroke.

Other options. You may choose other care, including care from a medical doctor or physical therapist, medication, or no care. You may ask questions, decline any part of your care, or stop care at any time.

Our team. Our doctors work as a team, and you may be cared for by any of our doctors. We are a teaching practice: students and associates may observe or help under supervision. Tell us if you would rather not have a student present.

Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Lazar Upper Cervical Chiropractic Clinic, PLC · Effective November 1, 2026

Our promise

Your privacy matters to us. Federal law (HIPAA) requires us to protect your health information, to give you this notice of our legal duties and privacy practices, to notify you if a breach of your unsecured health information occurs, and to follow the notice currently in effect.

What information we protect

Protected health information includes your health history, exam findings and reports, imaging and motion studies, billing information, and information we receive from other providers, whether electronic, written, recorded or verbal. Some information about alcohol or drug use may have additional federal protections; when they apply, we will not share that information without your written permission unless the law requires it, and redisclosure may be restricted.

How we use and share your information

• To provide your care: for example, sharing your X-rays with a radiologist, or coordinating with your other providers.
• To get paid: for example, billing you, or providing records to an auto insurer or workers' compensation carrier for a claim.
• To run our practice: for example, training, quality improvement, legal compliance and business operations. We work with secure vendors under written privacy agreements.
• To remind and inform you: appointment reminders, and information about our services, using the contact preferences you choose.
• With people involved in your care: such as a family member, unless you object.

Other uses the law allows without your permission

We may share information when required by law; for public health and safety, including reporting abuse or neglect; for health oversight such as audits and inspections; in response to a court order, subpoena or other lawful process; to law enforcement in limited cases; to coroners and medical examiners; for organ and tissue donation; for research approved under privacy safeguards; to prevent a serious threat to health or safety; for military, veterans and national security purposes; and for workers' compensation.

Uses that require your written permission

We need your written authorization to use your information for marketing, to sell it, or for any use not described in this notice. We never sell patient information. We will never use your name, image, recording, or identifiable story without your written permission. You may revoke an authorization in writing at any time, except for what we already did in reliance on it.

Teaching practice and education

We are a teaching practice. Students and associates may observe or participate in care under supervision; all sign confidentiality agreements and complete privacy training. Tell us if you'd rather not have a student present. We may use de-identified case examples for teaching and education.

Electronic communication

We may communicate by text, email, patient portal, and video visit, based on the preferences you choose. Electronic communication carries some security risk, and you may opt in or out at any time. Phone calls may be recorded for documentation and quality purposes.

Your rights

You have the right to:

• See or get a copy of your records, including an electronic copy, usually within 30 days. We may charge a reasonable, cost-based fee.
• Ask us to correct your records. If we say no, we'll tell you why in writing.
• Ask us to limit what we use or share. We are not required to agree, except that if you pay for a service in full out of pocket, you may ask us not to share it with your health plan, and we will agree unless the law requires us to share it.
• Ask us to contact you in a specific way or at a specific place. We will agree to reasonable requests.
• Get a list of certain disclosures we have made in the past six years.
• Get a paper copy of this notice at any time.
• Choose someone, such as a legal guardian, to act for you.
• File a complaint without retaliation.

Changes to this notice

We may change this notice, and the change will apply to all information we hold. The current notice is posted in our office and on our website, and is available at the front desk.

Questions and complaints

Privacy Officer, Lazar Upper Cervical Chiropractic Clinic, PLC · 203 S. Zeeb Rd., Suite 106, Ann Arbor, MI 48103 · (734) 274-5107 · privacy@lazaruppercervical.com

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, 200 Independence Avenue S.W., Washington, D.C. 20201, 1-877-696-6775, or www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.