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HIPAA Notice of Privacy Practices

TABLE OF CONTENTS
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Last Updated: April 29, 2026

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.

Our Commitment to Your Privacy

At EW Motion Therapy, we understand that your health information is personal and private. We are committed to protecting your protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH), and all applicable state and federal laws.

This Notice of Privacy Practices describes how we may use and disclose your protected health information, your rights regarding that information, and our legal duties to protect it. We are required by law to maintain the privacy of your PHI, provide you with this notice of our legal duties and privacy practices, notify you if your unsecured PHI is breached, and follow the terms of the notice currently in effect.

This notice applies to all records related to your care that EW Motion Therapy creates or maintains, whether at our Birmingham, Tuscaloosa, or Hoover locations.

What Is Protected Health Information?

Protected health information (PHI) is individually identifiable health information that relates to your past, present, or future physical or mental health condition, the healthcare services you receive, or payment for those services. This includes information in your medical records, billing records, and any other records we use to make decisions about your care.

How We May Use and Disclose Your Protected Health Information

 

Uses and Disclosures That Do Not Require Your Authorization

We may use and disclose your PHI without your written authorization for the following purposes:

Treatment We may use your PHI to provide, coordinate, and manage your physical therapy care and related services. This includes sharing information with other healthcare providers involved in your treatment, such as your referring physician, specialists, or other therapists within our practice. For example, if you are receiving both physical therapy and clinical Pilates services, your physical therapist may discuss your progress with your Pilates instructor to coordinate your care plan.

Payment We may use and disclose your PHI to obtain payment for the services we provide. This includes submitting claims to your health insurance company, Medicare, Medicaid, or other payers. We may also disclose information to your insurance company to obtain prior authorization for services or to determine your eligibility for benefits. For example, we may send your diagnosis and treatment information to your insurer to receive payment for your physical therapy sessions.

Healthcare Operations We may use and disclose your PHI for our internal operations, including quality assessment and improvement activities, reviewing the competence and qualifications of our staff, conducting training programs, business planning, customer service, and other administrative functions. For example, we may review your records to evaluate the effectiveness of our treatment protocols or to train new staff members.

Appointment Reminders and Health-Related Communications We may contact you to remind you of upcoming appointments or to provide information about treatment alternatives, health-related benefits, or services that may be of interest to you. We may contact you by phone, text message, email, or mail for these purposes.

Individuals Involved in Your Care Unless you object, we may disclose your PHI to a family member, close friend, or other person you identify as being involved in your care or payment for your care. We may also disclose information to someone who helps with your transportation to appointments or assists with your home exercise program. If you are unable to agree or object due to incapacity or emergency, we may disclose information if we determine it is in your best interest.

Business Associates We may disclose your PHI to third-party business associates who perform services on our behalf, such as billing companies, electronic health record providers, or IT service providers. These business associates are required by contract and law to protect your information and use it only for the purposes we specify.

As Required by Law We will disclose your PHI when required to do so by federal, state, or local law.

Public Health Activities We may disclose your PHI to public health authorities for purposes such as preventing or controlling disease, injury, or disability; reporting births and deaths; reporting child abuse or neglect; reporting adverse events related to medications or medical devices; or notifying individuals of recalls.

Health Oversight Activities We may disclose your PHI to health oversight agencies for activities authorized by law, including audits, investigations, inspections, licensure, and other proceedings related to the oversight of the healthcare system.

Judicial and Administrative Proceedings We may disclose your PHI in response to a court order or administrative tribunal. We may also disclose information in response to a subpoena, discovery request, or other lawful process, subject to certain conditions and protections.

Law Enforcement Purposes We may disclose your PHI to law enforcement officials for certain purposes, including reporting certain types of wounds or injuries, complying with court orders or subpoenas, identifying or locating suspects or missing persons, or reporting crimes that occur on our premises.

Coroners, Medical Examiners, and Funeral Directors We may disclose your PHI to coroners, medical examiners, and funeral directors to carry out their lawful duties.

Organ and Tissue Donation If you are an organ donor, we may disclose your PHI to organizations involved in the procurement, banking, or transplantation of organs, eyes, or tissue.

Research Under certain circumstances, we may use or disclose your PHI for research purposes, provided the research has been approved by an institutional review board or privacy board that has established protocols to ensure the privacy of your information.

Serious Threats to Health or Safety We may use or disclose your PHI when necessary to prevent or lessen a serious and imminent threat to your health and safety or the health and safety of the public or another person.

Specialized Government Functions We may disclose your PHI for military and veterans' activities, national security and intelligence activities, protective services for the President, and other specialized government functions as required by law.

Workers' Compensation We may disclose your PHI as authorized by and necessary to comply with workers' compensation laws and other similar programs.

Uses and Disclosures That Require Your Written Authorization

For uses and disclosures not described above, we will obtain your written authorization before using or disclosing your PHI. This includes:

  • Most uses and disclosures of psychotherapy notes (if applicable)
  • Uses and disclosures of your PHI for marketing purposes
  • Disclosures that constitute a sale of your PHI
  • Other uses and disclosures not described in this notice

You have the right to revoke your authorization at any time by submitting a written revocation to our Privacy Officer. However, your revocation will not affect any uses or disclosures we made in reliance on your authorization before we received your revocation.

Your Rights Regarding Your Protected Health Information

You have the following rights regarding the PHI we maintain about you:

Right to Access Your Records You have the right to inspect and obtain a copy of your PHI contained in your medical and billing records. To request access, submit a written request to our Privacy Officer. We may charge a reasonable fee for copying, mailing, or other supplies associated with your request. In certain limited circumstances, we may deny your request, and you may have the right to have the denial reviewed.

Right to Request Amendments If you believe that information in your records is incorrect or incomplete, you have the right to request that we amend your PHI. To request an amendment, submit a written request to our Privacy Officer explaining why you believe the information should be changed. We may deny your request in certain circumstances, such as if we did not create the information or if we determine the information is accurate and complete. If we deny your request, you have the right to submit a written statement of disagreement.

Right to an Accounting of Disclosures You have the right to request a list of certain disclosures we have made of your PHI. This accounting does not include disclosures made for treatment, payment, or healthcare operations, or disclosures made with your authorization. To request an accounting, submit a written request to our Privacy Officer specifying the time period you want covered (up to six years prior to the date of your request). The first accounting in any 12-month period is free; we may charge a reasonable fee for additional requests.

Right to Request Restrictions You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations. You also have the right to request restrictions on disclosures to family members or others involved in your care. We are not required to agree to your request, except in one situation: if you pay for a service out of pocket in full and request that we not disclose information about that service to your health plan, we must honor that request unless disclosure is required by law.

Right to Request Confidential Communications You have the right to request that we communicate with you about your health information in a certain way or at a certain location. For example, you may request that we contact you only at your work phone number or send correspondence to a different address. We will accommodate reasonable requests. To make a request, submit it in writing to our Privacy Officer.

Right to a Paper Copy of This Notice You have the right to obtain a paper copy of this Notice of Privacy Practices at any time, even if you previously agreed to receive it electronically. To obtain a paper copy, contact our Privacy Officer or request one at any of our clinic locations.

Right to Be Notified of a Breach You have the right to be notified if your unsecured PHI is breached. We will notify you of any breach affecting your PHI as required by law.

Our Duties

We are required by law to:

  • Maintain the privacy of your PHI
  • Provide you with this notice of our legal duties and privacy practices
  • Notify you if your unsecured PHI is breached
  • Follow the terms of the notice currently in effect

We reserve the right to change our privacy practices and the terms of this notice at any time, provided such changes are permitted by law. Any changes will apply to all PHI we maintain, including information created or received before the changes were made. When we make a significant change to our privacy practices, we will post the revised notice on our website and make copies available at our clinic locations.

How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services.

To file a complaint with EW Motion Therapy: Contact our Privacy Officer using the information provided below. Please describe your concern in writing, including any relevant dates and details.

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

You will not be retaliated against for filing a complaint.

Contact Information

If you have questions about this notice or would like to exercise any of your rights, please contact our Privacy Officer:

Privacy Officer
Christopher Brandt
EW Motion Therapy
3125 Independence Drive, Suite 300B
Homewood, AL 35209
Phone: (205) 879-7501
email: info@ewmotiontherapy.com

Acknowledgment of Receipt

You will be asked to sign an acknowledgment confirming that you have received a copy of this Notice of Privacy Practices when you begin care at EW Motion Therapy. If you have any questions before signing, please ask a member of our team.