Notice of Patient Privacy Practices


This Notice of Privacy Practices (NPP) describes how we uphold patient privacy. It describes how your protected health information (PHI) may be used and disclosed and how you can access this information. Please review it carefully.

Our Responsibilities:

We commit ourselves fully to maintaining patient privacy and security of your PHI. We are required by law to:

    • Keep your PHI private.

    • Provide you with this NPP explaining our privacy practices and your rights.

    • Follow the terms outlined in this NPP.


We will obtain your written authorization for any uses or disclosures of your PHI not covered by this NPP or required by law. You have the right to revoke an authorization in writing at any time.

How We Use and Disclose Your PHI:

We may use and disclose your PHI for various purposes, including

    • Treatment: We may use or disclose your PHI to provide, coordinate, or manage your physical therapy and related services. This may include sharing information with other healthcare providers involved in your treatment.

    • Emergencies: We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your care in the event of an emergency.

    • Public Health: As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.

    • Judicial and Administrative Proceedings: We may disclose your health information in the course of any administrative or judicial proceeding.

    • Public Safety: We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or to the general public.

    • Change of Ownership: In the event that we sell or merge Perform & Restore Physical Therapy with another organization, your health information/record will become the property of the new owner.

Your Rights:

You have the following rights regarding your PHI:

    • Right to Access: You have the right to request access to your PHI, which we will provide within 30 days.

    • Right to Amend: You may request changes to your PHI if you believe it is inaccurate or incomplete. We will respond within 60 days.

    • Right to an Accounting of Disclosures: You can request a list of disclosures we have made of your PHI in the last seven years, except for disclosures related to treatment or healthcare operations.

    • Right to Request Restrictions: You may request restrictions on how we use or disclose your PHI. Please be advised, however, that we are not required to agree to the restriction that you requested.

    • Right to Request Confidential Communications: You can request that we communicate with you about your PHI in a certain way or at a certain location.

    • Right to a Paper Copy: You have the right to receive a paper copy of this NPP upon request.

Changes to this NPP:

We reserve the right to change our privacy practices and the terms of this NPP.

If you have any questions or concerns about anything in this notice, please contact us.