Notice of Privacy Practices

At Sage Physical Therapy, we are committed to protecting your medical information.  Creation of a medical record detailing the treatment and services you receive helps us provide you with quality care.  Your information will not be sold, or listed for the purposes of advertisement, solicitation, or fundraising. 

This Patient Notice of Privacy Policies describes the health information we collect and shows the ways in which your medical information can be used. You must sign that you have received the Notice of Privacy Policies statement before you begin treatment.

Each time you visit Sage Physical Therapy, a record of your visit is made. This medical record typically contains your symptoms, examination results and objective measures, diagnosis, treatment, and a plan of care.

Your Rights

You have the right to:

• Obtain a copy of the notice of privacy practices upon request

• Inspect and copy your health record

• Request a correction or change to your health record

• Make a list of who your medical record was shared with

• Request confidential communication of your medical record

• Request a restriction on the information we share

• Revoke your permission for use or sharing of your medical record except to the extent that action has already been taken

Our Responsibilities

We are required to:

• Maintain the privacy of your medical records

• Provide you with this notice as to our privacy practices and abide by the terms of this notice

• Notify you if we are unable to agree to a request for a change in your medical record

• Notify you if we are unable to agree to a request for restriction in the information we share

• Accommodate reasonable requests you may have to communicate your medical records by alternative locations

We reserve the right to change our practices and to make the new provisions effective for all medical records we maintain.

We will not use or share your medical record without permission, except as described in this notice. We will also discontinue the use of the Patient Notice of Privacy Practices and share your medical record after we have received notice in writing that you have revoked your permission.

Use and Sharing of Health Information

The law allows us to use your medical records without your permission for treatment, payment, and business operations. The following are some examples: patient billing, third party billing, quality of care and improved services, other specialty care, caregiver/ family member notification/ communication, research, organ and tissue donation, marketing, fundraising, Food and Drug Administration (FDA), Workers Compensation, law enforcement, and public health, patient registration, to obtain medical records from former practitioners, in conversations with colleagues for opinion/care, or for other reasons directly related to your care at Sage Physical Therapy.

Federal law makes provision for your medical records to be released to an appropriate health over sight agency, public health authority or attorney, provided that a work force member of business associate believes in good faith that we have engaged in unlawful conduct of have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.

For more information or to report a problem

If you have any questions or require additional information, please contact us at 919.627.1844 or email sagephysicaltherapync@gmail.com.