1.  Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office - we are not required to grant the request but we will comply with any request granted.
2. Obtain a paper copy of the Notice of Privacy Practices for Protected Health Information ("Notice") by making a request at our office.
3. Inspect and copy your health record billing record - you may exercise this right by delivering the request; appeal a denial of access to your protected health information except in certain circumstances.
4. Request that your health care record be amended to correct incomplete or incorrect information by delivering a written  request to our office using the form we provide to you upon request.  (The physical therapist or other health care provider is not required to make such amendments); you may file a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your Protected Health Information;
5. Right to receive an accounting of disclosures of your Protected Health Information as required to be maintained by law by delivering a written request to our office using the form we provide to you upon request.  An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course of providing care;
6. Right to confidential communication by requesting that communication of your Protected Health Information  be made by alternative means or at an alternative location by delivering the request in writing to our office using the form we give you upon request.

If you want to exercise any of the above rights, please contact: in person or in writing, during normal hours.  He/she will provide you with assistance on the steps to take to exercise your rights. You have the right to review this Notice before signing the consent authorizing use and disclosure of your protected health information for treatment, payment, and health care operations purposes.