Notice of privacy practices.

Your rights

When it comes to your health information, you have certain rights. This section explains your rights and some of my responsibilities to help you.

• Get a copy of your health and claims records. You can ask to see or get an electronic or paper copy of your medical record and other health information I have about you. I will provide a copy or a summary, usually within 30 days of your request, and may charge a reasonable, cost-based fee.
• Ask me to correct your record. You can ask me to correct health information about you that you think is incorrect or incomplete. I may say no, but I will tell you why in writing within 60 days.
• Request confidential communications. You can ask me to contact you in a specific way (for example, a particular phone or email) or to send mail to a different address. I will say yes to all reasonable requests.
• Ask me to limit what I use or share. You can ask me not to use or share certain health information for treatment, payment, or operations. I am not required to agree if it would affect your care. If you pay for a service in full out of pocket, you can ask me not to share that information with your health insurer, and I will say yes unless a law requires me to share it.
• Get a list of those I’ve shared information with. You can ask for a list (accounting) of the times I’ve shared your health information for six years before the date you ask, who I shared it with, and why. It will include all disclosures except those about treatment, payment, and health care operations, and certain others, such as any you asked me to make. I will provide one list a year for free and may charge a reasonable, cost-based fee for another within 12 months.
• Get a copy of this notice. You can ask for a paper copy of this notice at any time.
• 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. I will make sure the person has this authority before I take any action.
• File a complaint if you feel your rights are violated. You can complain by contacting me using the information at the end of this notice, or by filing 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; 1-877-696-6775; or hhs.gov/ocr/complaints. I will not retaliate against you for filing a complaint.

Your choices

For certain health information, you can tell me your choices about what I share. In these cases, you have both the right and the choice to tell me to share information with your family, close friends, or others involved in your care, or to share information in a disaster relief situation. If you are not able to tell me your preference, for example if you are unconscious, I may share your information if I believe it is in your best interest, and may also share it when needed to lessen a serious and imminent threat to health or safety.

I will never share your information for marketing purposes or sell your information unless you give me written permission.

How I use and share your health information

• To treat you. I can use your health information and share it with other professionals who are treating you, for example your OB, midwife, or primary care doctor.
• To run the practice. I can use and share your health information to run the practice, improve your care, and contact you when necessary.
• To bill for your services. I can use and share your health information to bill and get payment, for example when preparing a superbill you submit to your insurance.

I am allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. I have to meet many conditions in the law before I can share your information for these purposes:

• Helping with public health and safety issues, such as preventing disease, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.
• Doing research, under the conditions the law sets.
• Complying with the law, including if the Department of Health and Human Services wants to see that I’m complying with federal privacy law.
• Responding to organ and tissue donation requests, and working with a medical examiner or funeral director.
• Addressing workers’ compensation, law enforcement, and other government requests, such as for health oversight activities or special government functions.
• Responding to lawsuits and legal actions, such as a court or administrative order or a subpoena.

My responsibilities

• I am required by law to maintain the privacy and security of your protected health information.
• I will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• I must follow the duties and privacy practices described in this notice and give you a copy of it.
• I will not use or share your information other than as described here unless you tell me I can in writing. If you tell me I can, you may change your mind at any time by letting me know in writing.

Changes to this notice

I can change the terms of this notice, and the changes will apply to all information I have about you. The new notice will be available on request, in the practice, and on this website.

Contact

Privacy official: Dr. Jessica Cody, PT, DPT, Haven Physical Therapy, Simpsonville, South Carolina. hello@havenptsc.com.

Effective November 2026.