HIPAA Notice of Privacy Practices
Effective Date: September 1, 2025
This Notice describes how your medical information may be used and disclosed and how you can access this information. Please review it carefully.
At Sage Physical Therapy and Wellness, we are committed to protecting your privacy and the confidentiality of your health information. This Notice explains how we may use and share your information and outlines your rights regarding your medical records.
How We May Use and Disclose Your Health Information
We may use or disclose your health information in the following ways:
Treatment: To provide, coordinate, or manage your physical therapy and healthcare services.
Payment: To obtain payment for services provided, including billing and claims management.
Required by Law: When disclosure is required by federal, state, or local law.
Public Health & Safety: To prevent or reduce a serious threat to your health or the health and safety of others.
Other Permitted Uses: Such as workers’ compensation, law enforcement, or regulatory agencies, when legally authorized.
We will obtain your written authorization before using or disclosing your health information for any purpose not described in this Notice. You may revoke your authorization in writing at any time.
Your Rights Regarding Your Health Information
You have the following rights:
Right to Access: You may request to review or obtain a copy of your health records.
Right to Amend: You may request corrections to your records if you believe information is incorrect or incomplete.
Right to an Accounting of Disclosures: You may request a list of certain disclosures of your health information.
Right to Request Restrictions: You may request limits on how your information is used or disclosed, though we are not always required to agree.
Right to Confidential Communications: You may request that we communicate with you in a specific way (for example, only by phone or mail).
Right to a Paper Copy of This Notice: You may request a printed copy of this Notice at any time.
Our Responsibilities
Sage Physical Therapy and Wellness is required by law to:
Maintain the privacy of your health information.
Provide you with this Notice of our legal duties and privacy practices.
Notify you if there is a breach of your protected health information.
Abide by the terms of the Notice currently in effect.
We reserve the right to change this Notice at any time. Changes will apply to all health information we maintain and will be posted on our website.
Questions or Complaints
If you have questions about this Notice or believe your privacy rights have been violated, you may contact us at:
Sage Physical Therapy and Wellness
Phone: 817-350-6110
Email: sarah@sagephysicaltherapytx.com
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
Acknowledgment
By continuing to use our services, you acknowledge receipt of this HIPAA Notice of Privacy Practices.