Notice of Privacy Practices

You have the right to:

Get a copy of your health information

You may ask to inspect or receive an electronic or paper copy of your medical record and other health information we maintain about you.

We generally will provide a copy or summary within the time required by law. We may charge a reasonable, cost-based fee when permitted by law.

Ask us to correct your health information

You may ask us to correct health information that you believe is inaccurate or incomplete.

We may deny your request in circumstances permitted by law. If we deny your request, we will explain why in writing.

Request confidential communications

You may ask us to contact you in a particular way or at a particular location.

For example, you may ask us to call a specific telephone number.

We will accommodate reasonable requests.

Ask us to limit what we use or disclose

You may ask us not to use or disclose certain health information for treatment, payment, or health care operations.

We are not always required to agree.

If you pay for a health care service or item completely out of pocket, you may ask us not to disclose information about that service or item to your health insurer for payment or health care operations. We will honor that request unless disclosure is required by law.

Get a list of certain disclosures

You may ask for an accounting of certain disclosures of your health information made during the six years before your request.

The accounting does not include every disclosure, such as certain disclosures for treatment, payment, health care operations, or disclosures you specifically requested.

We will provide one accounting during a 12-month period at no charge. We may charge a reasonable, cost-based fee for additional requests during that period.

Get a copy of this notice

You may request a paper or electronic copy of this Notice at any time.

Choose someone to act for you

If another person has legal authority to act on your behalf, such as a legal guardian or someone holding a valid health care power of attorney, that person may exercise your privacy rights as permitted by law.

We may verify that person's authority before acting on a request.

File a complaint

If you believe your privacy rights have been violated, you may contact Streamline Physical Therapy at joan@streamlineptva.com or (703) 475-8755.

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.