REISS PHYSICAL THERAPY & REHAB, INC.

HIPAA RIGHTS AND DISCLOSURES 

Your Information. Your Rights. Our Responsibilities.

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.

Your Rights

You have the right to:

Get an electronic or paper copy of your medical record
You can ask to see or get a copy of your medical record and other health information we have about you. We will usually provide a copy or summary within 30 days. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record
If you believe your health information is incorrect or incomplete, you can ask us to correct it. We may deny your request, but if we do, we will tell you why in writing within 60 days.

Request confidential communications
You can ask us to contact you in a specific way (for example, home phone, office phone, or mail to a different address). We will say “yes” to reasonable requests.

Ask us to limit what we use or share
You can ask us not to use or share certain information for treatment, payment, or operations. We are not required to agree, and we may say “no” if it would affect your care.
If you pay in full out-of-pocket for a service, you may request that we not share that information with your health plan. We will say “yes” unless a law requires us to share it.

Get a list of those with whom we’ve shared information
You can ask for an accounting of disclosures we made in the six years prior to your request. We will include all disclosures except those related to treatment, payment, operations, and certain other exceptions. The first list is free; we may charge a reasonable fee for additional requests within a 12-month period.

Get a copy of this Notice
You can ask for a paper copy of this Notice at any time, even if you agreed to receive it electronically. We will provide it promptly.

Choose someone to act for you
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will verify their authority before taking any action.

File a complaint if you feel your rights have been violated
You can file a complaint with our office (see contact information below) or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you have the right and choice to tell us how we share it.

  • You can direct us to share information with your family, close friends, or others involved in your care.

  • You can direct us to share information in a disaster relief situation.

If you are unable to tell us your preference (for example, if you are unconscious), we may share your information if we believe it is in your best interest. We may also share when needed to lessen a serious and imminent threat to health or safety.

In these cases we will not share your information without your written permission:

  • Marketing purposes

  • Sale of your information

  • Most sharing of psychotherapy notes

Fundraising: We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

We typically use and share your health information in the following ways:

  • Treat you – We can use your health information and share it with other professionals who are treating you.
    Example: A doctor treating you for an injury asks about your therapy progress.

  • Run our organization – We can use and share your health information to run our practice, improve your care, and contact you when necessary.
    Example: We use health information about you to manage your treatment and services.

  • Bill for your services – We can use and share your health information to bill and get payment from health plans or other entities.
    Example: We give information about you to your health insurance plan so it will pay for your services.

We may also use or share your information as required or permitted by law, including:

  • To prevent or control disease, report abuse or neglect, or reduce serious threats to health or safety

  • For health oversight activities and compliance with the law

  • For approved research

  • With coroners, medical examiners, or funeral directors

  • For workers’ compensation, law enforcement, and other government requests

  • In response to a court order, subpoena, or other legal process

Other uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke your authorization in writing at any time, except where we have already relied on it.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information (PHI).

  • We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

  • We must follow the duties and privacy practices described in this Notice and provide you with a copy.

  • We will not use or share your information other than as described here unless you authorize us in writing. If you authorize, you may revoke in writing at any time.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

Complaints & Contact Information

If you have any questions about this Notice or believe your privacy rights have been violated, you may contact us:

Reiss Physical Therapy & Rehab, Inc.
P.O. Box 801060
Santa Clarita, CA 91380-1060
Phone: (323) 965-7713
Email: diana@reisspt.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Online: www.hhs.gov/ocr/privacy/hipaa/complaints/

We will not retaliate against you for filing a complaint.

Effective Date: September 9, 2025

Reiss Physical Therapy & RehaB, INC.
(323) 965-7713 / diana@reisspt.com