Notice of Privacy Practices
Effective Date: July 16th, 2026
Required Header Statement
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Commitment to Your Privacy
ProHealth Physical Therapy and Pilates Studio is committed to protecting the privacy of your protected health information (PHI). PHI is information about you that may identify you and that relates to your past, present, or future physical or mental health, the healthcare we provide to you, or payment for that care.
This Notice describes how ProHealth may use and disclose your PHI to carry out treatment, payment, and healthcare operations, and for other purposes permitted or required by law. It also describes your rights regarding your PHI and certain obligations we have regarding the use and disclosure of your PHI.
How We May Use and Disclose Your PHI
ProHealth's existing NPP content must be inserted here. The HIPAA-required structure is provided below as section headings. The actual language under each heading must come from ProHealth's compliance-approved NPP.
For Treatment
To provide treatment, including coordination with physicians, surgeons, other PT providers, billing staff, and any other parties involved in your care. ]
For Payment
To obtain payment for services, including insurance billing, claims processing, eligibility verification, and any third-party billing service relationships.
For Healthcare Operations
For healthcare operations, including quality improvement, training, accreditation, business management, and compliance activities.
Other Permitted Uses and Disclosures
As required by law, public health activities, health oversight activities, judicial and administrative proceedings, law enforcement purposes, coroners and funeral directors, organ donation, research, serious threats to health or safety, military and veterans activities, national security and intelligence, protective services, inmates and correctional institutions, and workers' compensation.
Uses and Disclosures Requiring Your Written Authorization
Uses and disclosures that require written patient authorization, including: most uses and disclosures of psychotherapy notes (if applicable), uses and disclosures for marketing purposes, and sales of PHI.
Your Rights Regarding Your PHI
Right to Inspect and Copy
You have the right to inspect and obtain a copy of PHI maintained by ProHealth, with applicable exceptions, fees, and process for requesting access.
Right to Amend
You have the right to request amendment of PHI, the process for submitting a request, ProHealth's right to deny amendment under certain conditions, and the patient's right to submit a statement of disagreement.
Right to an Accounting of Disclosures
You have the right to receive an accounting of certain disclosures of PHI made by ProHealth, with applicable timeframes and exceptions.
Right to Request Restrictions
You have the right to request restrictions on certain uses and disclosures of PHI, ProHealth's obligation to agree to certain restrictions related to out-of-pocket payment, and process for submitting a restriction request.
Right to Request Confidential Communications
You have the right to request that PHI communications be made by alternative means or at alternative locations (for example, mail to a specific address rather than a home phone).
Right to a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice upon request, even if you have agreed to receive it electronically. Contact our office to request a paper copy.
Right to Be Notified of a Breach
You have the right to be notified following a breach of your unsecured PHI as required by HIPAA.
Our Legal Duties
ProHealth is required by law to:
- Maintain the privacy of your PHI
- Provide you with this Notice of our legal duties and privacy practices regarding your PHI
- Notify you following a breach of unsecured PHI
- Abide by the terms of this Notice currently in effect
ProHealth reserves the right to change this Notice and to make the revised Notice effective for PHI we already have about you as well as any PHI we receive in the future. The current version of this Notice will be available at our office and on this website. The effective date is shown at the top of this Notice.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with ProHealth or with the Secretary of the United States Department of Health and Human Services. You will not be retaliated against for filing a complaint.
To File a Complaint with ProHealth
Contact our designated Privacy Officer:
Karyn Staples
ProHealth Physical Therapy and Pilates Studio
1777 Georgian Park
Peachtree City, GA 30269
Phone: 770-487-1931
Email: ptcfrontoffice@phrehab.com
To File a Complaint with HHS
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Contact Information for Questions
If you have any questions about this Notice or your privacy rights, please contact our Privacy Officer at the information above.