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Atlantic Physical Therapy & Rehabilitation, Inc.
NOTICE OF PATIENT INFORMATION PRACTICES

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.

ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC.'s LEGAL DUTY

ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC. is required by law to protect the privacy of your personal health information, provide this notice about our information practices and follow the information practices that are described herein.

USES AND DISCLOSURES OF HEALTH INFORMATION

ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC.
uses your personal health information primarily for treatment; obtaining payment for treatment; conducting internal administrative activities and evaluating the quality of care that we provide.
For example, ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC. may use your personal health information to contact you to provide appointment reminders, or information about treatment alternatives or other health related benefits that could be of interest to you.

ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC. may also use or disclose your personal health information without prior authorization for public health purposes, for auditing purposes, for research studies and for emergencies. We also provide information when required by law.

In any other situation, ATLANTIC PHYSICAL THERAPY & REHABILITATION, 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 to stop future disclosures at any time.

ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC. may change its policy at any time. When changes are made, a new Notice of Information Practices will be posted in the waiting room and patient exam areas and will be provided to you on your next 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 not use or disclose your personal health information for treatment, payment and administrative purposes except when specifically authorized by you, when required by law or in emergency circumstances. ATLANTIC PHYSICAL THERAPY & REHABILITATION, 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 ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC. may have violated 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 practice manager at the address listed below. You may also send a written complaint to the US Department of Health and Human Services. For further information on ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC.'s health information practices or if you have a complaint, please contact the following person:

Dargan Ervin, P.T., M.H.S., Compliance Officer
ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC.
3650 Coalition Drive
Myrtle Beach, SC 29577
Telephone: 843-293-7713Fax: 843-293-1855
edervin@sc.rr

 Myrtle Beach Office
3650 Coalition Drive
P.O. Box 1145
Myrtle Beach, S.C. 29578
(843) 293-7713
FAX (843) 293-1855
North Myrtle Beach
505 Hwy. 17 North
North Myrtle, S.C. 29582
(843) 249-7232
FAX (843) 280-0206
Conway
235 Singleton Ridge Road
P.O. Box 2596
Conway, S.C. 29528
(843) 234-0015
FAX (843) 234-0017