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HIPAA Notice of Privacy Practices

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HIPAA- The Health Insurance Portability Accountability Act. This law is the first comprehensive Federal protection for the privacy of personal health information, passed by Congress in 1996, and implemented in April 2003. more

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Next Step Acknowledgement Form

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Next Step Acknowledgement Form
  • We understand that information concerning your health is important to you. We are committed to maintaining privacy and protecting information about you.
  • Next Step Physical Therapy, LLC creates record of care and services performed while under our care. This information is recorded to help us in providing care and also in keeping with legal requirements designed to protect you.
  • This notice applies to all records of your care generated by and provided to Next Step Physical Therapy, LLC and MyNuMi Fitness, LLC (the continued care provider) whether made by your personal physician, or others working with you on behalf of Next Step Physical Therapy, LLC and/or MyNuMi Fitness, LLC.
  • This Notice will explain ways in which we may use or disclose health information about you. We also describe your rights to the health information we keep about you and describe certain obligations we have regarding use or disclosure of your health information.

The law requires us to:

  • Make certain that health information that describes you, is kept private.
  • Give you this notice of our legal duties and privacy practices with regard to your health.
  • Follow the terms of this notice currently in effect.

How we may use and disclose health information about you:

  • For treatment
  • For payment
  • For check-in at the front desk for Non-Members
  • For Health Care Operations
  • For appointment reminders
  • As Law requires
  • As required by Military or Veterans and Workers Compensation
  • Public Health Risk
  • Law Enforcement
  • Health Disputes
  • Coroners, Health examiners and Funeral Directors
  • National Security and Intelligence Activities
  • Protective service for the President and Others

Your rights regarding health information about you:

  • Rights to inspect and copy
  • Right to amend
  • Right to accounting of disclosure
  • Right to request Restrictions
  • Right to request confidential communications concerning your health records
  • Right to paper copy of this notice

Change of notice.

  • We reserve the right to change this notice. We will retain a copy of this notice in our facility.

If you believe your privacy rights have been violated you may file your complaint with us. All complaints must be in writing and addressed to the General Manager of the facility in which you treated.

We will request that you sign a separate form  attesting to your understanding and receipt of this form.

Form MINS051804 Version 2


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