HIPAA Notice

Effective Date: 16 May 2026

This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

Momentum Mobile Physical Therapy is committed to protecting the privacy and confidentiality of your health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

Our Commitment to Your Privacy

We understand that your medical information is personal. We are required by law to:

• Maintain the privacy and security of your protected health information (PHI)

• Provide you with this Notice explaining our legal duties and privacy practices

• Follow the terms of the Notice currently in effect

• Notify you promptly if a breach occurs that may compromise your information

How We May Use and Disclose Your Information

We may use and disclose your protected health information for the following purposes:

Treatment

We may use your health information to provide, coordinate, or manage your physical therapy care and related services.

Example:
Discussing your treatment plan, reviewing medical history, or communicating with another healthcare provider involved in your care.

Payment

We may use or disclose your information to obtain payment for services provided.

Example:
Providing documentation or superbills for insurance reimbursement purposes.

Healthcare Operations

We may use your information for business and operational purposes necessary to run the practice effectively.

Example:
Scheduling appointments, quality improvement, recordkeeping, or administrative activities.

As Required by Law

We may disclose your information when required by federal, state, or local law.

Public Health and Safety

We may disclose information when necessary to prevent a serious threat to health or safety or when legally required for public health reporting.

Appointment Reminders and Communication

We may contact you by phone, voicemail, text message, or email regarding appointments, scheduling, or treatment-related matters unless you request otherwise.

Your Rights Regarding Your Health Information

You have the right to:

Access Your Records

Request copies of your medical and billing records.

Request Corrections

Ask us to correct inaccurate or incomplete information in your records.

Request Confidential Communications

Ask us to contact you in a specific way or at a specific location.

Request Restrictions

Ask us to limit how your information is used or disclosed.

Receive an Accounting of Disclosures

Request a list of certain disclosures of your health information.

Obtain a Copy of This Notice

You may request a paper or electronic copy of this Notice at any time.

Your Choices

You may choose how certain information is shared, including:

• Communication methods

• Appointment reminders

• Sharing information with family members or caregivers

Please let us know your preferences in writing whenever possible.

Our Responsibilities

Momentum Mobile Physical Therapy is required to:

• Protect the privacy of your health information

• Provide this Notice of Privacy Practices

• Follow the practices described in this Notice

• Comply with applicable federal and state privacy laws

Changes to This Notice

We reserve the right to change this Notice at any time. Updated versions will be posted on our website and available upon request.

Questions or Complaints

If you believe your privacy rights have been violated or if you have questions about this Notice, please contact:

Momentum Mobile Physical Therapy
Phone: 720-515-1758
Email:mgorski.momentumpt@gmail.com
Mailing Address: Denver Colorado, USA

You may also file a complaint with the U.S. Department of Health and Human Services without fear of retaliation.

Acknowledgment

By receiving services from Momentum Mobile Physical Therapy, you acknowledge that you have been offered access to this HIPAA Notice of Privacy Practices.