Effective Date: June 3, 2026

This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

Our Commitment to Your Privacy

Invigorate Physical Therapy is committed to protecting the privacy and confidentiality of your health information. We are required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice of our legal duties and privacy practices, and follow the terms of the Notice currently in effect.

Protected Health Information (PHI) includes information that identifies you and relates to your physical or mental health condition, healthcare services provided to you, or payment for those services.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your health information to provide, coordinate, or manage your healthcare treatment.

Examples include:

• Communicating with your physician or other healthcare providers

• Referring you to another provider

• Reviewing your medical history to develop a treatment plan

Payment

We may use and disclose your health information as necessary to collect payment for services provided to you.

Examples include:

• Processing payments for services rendered

• Maintaining financial records related to your care

• Communicating with you regarding invoices or outstanding balances

As a cash pay practice, we do not submit claims to insurance companies or disclose your health information to ensure for reimbursement purposes. A super bill will be provided to the patient to submit for potential reimbursement.

Cash-Pay Practice

Invigorate Physical Therapy operates as a cash-pay physical therapy practice. We do not participate with insurance plans or submit claims on behalf of patients. If you request documentation for personal submission to an insurance carrier, health savings account (HSA), flexible spending account (FSA), or other third party, we may provide the requested records upon your written authorization.

Healthcare Operations

We may use and disclose your health information for healthcare operations necessary to run our practice.

Examples include:

• Quality assessment and improvement activities

• Staff training and education

• Business management and administrative functions

• Compliance and licensing activities

Other Uses and Disclosures Permitted by Law

We may disclose your health information when required or permitted by law, including:

• Public health reporting

• Health oversight activities

• Judicial or administrative proceedings

• Law enforcement purposes

• Workers' compensation claims

• To prevent a serious threat to health or safety

• As required by federal, state, or local law

Uses Requiring Your Written Authorization

Any use or disclosure of your health information not described in this Notice will be made only with your written authorization.

You may revoke your authorization at any time in writing, except to the extent we have already relied upon it.

Your Rights Regarding Your Health Information

Right to Inspect and Obtain Copies

You have the right to inspect and obtain a copy of your health records, subject to certain legal limitations.

Right to Request Amendments

If you believe information in your record is incorrect or incomplete, you may request an amendment.

Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your health information. While we will consider your request, we are not required to agree to all requested restrictions.

Right to Confidential Communications

You may request that we communicate with you through alternative means or at alternative locations.

Right to Receive an Accounting of Disclosures

You have the right to request a list of certain disclosures we have made of your health information.

Right to Receive a Copy of This Notice

You have the right to receive a paper or electronic copy of this Notice at any time.

Our Responsibilities

We are required to:

• Maintain the privacy and security of your health information

• Provide you with this Notice of our privacy practices

• Notify you following a breach of unsecured protected health information when required by law

• Follow the terms of this Notice currently in effect

Changes to This Notice

We reserve the right to change our privacy practices and update this Notice at any time. Any revised Notice will apply to all health information we maintain and will be made available upon request and on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. You will not be penalized or retaliated against for filing a complaint.

To file a complaint with our practice, contact:

Privacy Officer
Invigorate Physical Therapy
Tiffani@invigoratept.org

You may also file a complaint with:

U.S. Department of Health and Human Services, Office for Civil Rights

Contact Information

If you have questions about this Notice or your privacy rights, please contact:

Invigorate Physical Therapy
Tiffani@invigoratept.org