THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO INFORMATION. PLEASE REVIEW IT CAREFULLY.

Park Physical Therapy's LEGAL DUTY

Park Physical Therapy Associates, Inc. is required by law to protect the privacy of your personal health information and we have provided this notice about our information practices and follow the information practices that are described herein.

USES AND DISCLOSURES OF HEALTH INFORMATION
Park Physical Therapy Associates, Inc. uses your personal health information primarily for treatment, obtaining payment for treatment, conducting internal administrative activities and evaluating the quality of care we provide. For example, Park Physical Therapy Associates, Inc. may use your personal health information to contact you to provide appointment reminders, information about treatment alternatives or other health related benefits that could be of interest to you.

Park Physical Therapy Associates, Inc. may also use or disclose your personal health information without prior authorization for public health purposes, auditing purposes, research studies or emergencies. We additionally provide information when required to do so by law.

In any other situation, Park Physical Therapy Associates, Inc.'s policy is to obtain your written authorization before disclosing your personal health information. If you provide us with a written authorization to release your information for any reason, you may later revoke that authorization and stop further disclosures at any time.

Park Physical Therapy Associates, Inc. may change its policy at any time. When changes are made, a new Notice of Information Practices will be posted on our company website and in the waiting rooms and patient treatment ares of our offices; additionally, the information will be provided to you upon your next office visit. You may also request an updated copy of our Notice of Information Practices at any time.

PATIENT'S INDIVIDUAL RIGHTS
You have the right to review or obtain a copy of your personal health information at any time. You have the right to request that we correct any inaccurate or incomplete information in your records. You also have the right to request a list of instances where we have disclosed your personal health information for reasons other than treatment, payment or other related administrative purposes.

You may also request, in writing, that we do not use or disclose your personal health information for treatment, payment or administrative purposes except when specifically authorized by you, when required by law or in an emergency situation. Park Physical Therapy Associates, Inc. will consider all such requests on a case by case basis, but the practice is not legally required to accept them.

CONCERNS AND COMPLAINTS
If you are concerned that Park Physical Therapy Associates, Inc. may have infringed upon your privacy rights or if you disagree with any decisions we have made regarding access or disclosure of your personal health information, please contact our business manager at the address listed below. You may also send a written complaint to the U.S. Department of Health and Human Services. For further information on Park Physical Therapy Associates, Inc.'s health information practices or if you have a complaint, please contact the business manager at the address below.

Park Physical Therapy Associates, Inc.
Kathleen Fulham, Business Manager
400 Cleveland Avenue, Highland Park, NJ 08904
Telephone: 732-828-0700 Fax: 732-828-0712