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Cancellation Policy 

Patients who cancel with fewer than 24 business hours' notice for any reason will be charged $100.  For example, you must call by Friday at 3:00 pm to cancel a Monday 3:00 pm appointment.  

The one exception to the 24 business hours rule is snow.  In the case of snow, I will follow the lead of the local schools and government offices.  For example, a two hour delay will exempt the 8:00am and 9:00am patients and school closures will exempt all patients from the cancellation policy for that day. 

Payment policy 

Payment is due at the time of service.  Cash, checks and credit/debit cards are accepted.  A 2.75% convenience fee will be added to all card transactions.

What are my privacy rights?

As your physical therapist, I believe your right to privacy is a fundamental part of your treatment; as such, I want you to understand my privacy practices and procedures. Should you have any questions regarding these policies please ask.

Information I collect about you: I collect personal information about you as part of the registration process, during the course of your care, and from other health care entities you utilize such as hospitals, physicians/specialists, and imaging facilities. This personal information includes items such as your name, address, phone number, email address, date of birth, employer, health history, and any other information you provide. 

How your information is used: The personal and health information gathered may be used and disclosed with your general consent for the following purposes: treatment, securing payment, health care operations, appointment reminders, as required by law, to avert a serious threat to health or safety, to military command authorities, to law enforcement, for public health risks, for workmen’s compensation, as ordered by a court, to coroners, and to national security agencies. 

 

Your rights regarding your privacy: You have the right to inspect, copy (copying fees apply), and amend your health information. You have the right to request a reasonable restriction or limitation on the health information I use or disclose about you for treatment, payment, or health care operations. You have the right to request confidential communication. All of the above requests must be made in writing and submitted to Hope Therapeutics, LLC. I will accommodate all reasonable requests. If you feel your privacy has been violated, you have the right to file a complaint with the Department of Health and Human Services. The complaint in no way influences your course of treatment with Hope Therapeutics, LLC. 

 

Acknowledgement of Receipt of this Notice:  I am required to supply you with a copy of this privacy policy and your signature on the consent form acknowledges that you have received it. 

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