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.

This notice applies to physical therapy and other health care services provide

Your Rights

AYou may ask to inspect or receive an electronic or paper copy of your health record. We will generally provide a copy or summary within 30 days and may charge a reasonable, cost-based fee. You may ask us to correct information you believe is incorrect or incomplete. We may deny the request in some circumstances and will explain the reason in writing, generally within 60 days.

You may request that we contact you in a particular way or at a different address. We will accommodate reasonable requests. You may ask us to limit use or disclosure for treatment, payment or health care operations, although we are not always required to agree. If you pay for a service in full out of pocket, you may ask us not to disclose information about that service to your health plan for payment or operations unless disclosure is required by law.

You may request an accounting of certain disclosures made during the six years before your request. One accounting in a 12-month period is free; additional requests may involve a reasonable, cost-based fee. You may request a paper copy of this notice at any time. A legally authorized personal representative, including a parent or legal guardian when applicable, may exercise your rights after we verify the person’s authority.

You may complain to Beta for Your Body using the contact information above or to the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue SW, Washington, DC 20201, 1-877-696-6775, or www.hhs.gov/hipaa/filing-a-complaint. We will not retaliate against you for filing a complaint.

Your Choices

You may tell us whether to share relevant information with family members, close friends or others involved in your care or payment, or for disaster-relief purposes. If you cannot express a preference, we may share information when we believe it is in your best interest or necessary to reduce a serious and imminent threat. We will obtain written authorization before using or disclosing your information for marketing, We do not sell health information.

How we may use and discolse your information

Treatment. We may use your information and share it with professionals involved in your care. Health care operations. We may use information to operate the practice, improve services, manage care, conduct quality activities and contact you when necessary. Payment. We may use or disclose information to receive payment, prepare an itemized receipt or superbill, or respond to a health plan when authorized or permitted.

We may also use or disclose information as permitted or required by law for public-health and safety activities; reporting abuse, neglect or domestic violence; health oversight; workers’ compensation; law-enforcement or other government functions; research that satisfies legal requirements; organ and tissue donation; coroners, medical examiners or funeral directors; court or administrative orders, subpoenas or other legal proceedings; and to prevent or reduce a serious threat to health or safety. We will meet applicable legal conditions before making these disclosures.

To the extent we hold substance use disorder patient records protected by 42 CFR part 2, we will not use or disclose those records in civil, criminal, administrative or legislative investigations or proceedings against you without your written consent or a court order accompanied by a subpoena, as applicable. If fundraising using Part 2 information were contemplated, you would receive advance notice and a choice about receiving such communications.

Our Responsabilities

We are required by law to maintain the privacy and security of protected health information, follow this notice, and provide you a copy. We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information. We will not use or disclose your information other than as described here unless you authorize it in writing. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.

Changes to this notice

We may change this notice and apply the revised terms to information we already maintain and information we receive in the future. The current notice will be available upon request and posted on our website. Contact the Beta for Your Body Privacy Contact with questions or requests concerning your privacy rights.