Notice of Privacy Practices

Achieve Wellness and Physical Therapy LLC

Effective Date: 10/08/2026

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.

This notice explains how Achieve Wellness and Physical Therapy LLC uses and protects your health information, your privacy rights, and how to contact us with questions or requests.

Privacy Contact

Amber Brady, PT, DPT, CMPT — Owner and Privacy Contact

Phone: 352-457-2515
Email: info@achievewellnesspt.com
Mailing Address: 6747 Newell Loop, The Villages, FL 34762
Website: https://www.achievewellnesspt.com

How We Use and Share Your Information

Treatment

We use your health information to evaluate you, plan and provide physical therapy, document your care, and coordinate with other healthcare professionals involved in your treatment. For example, we may discuss your progress or precautions with your treating physician.

Payment

We use information to collect payment, maintain billing records, and provide receipts or a requested superbill. We are a self-pay practice and do not submit insurance claims. This notice does not change our financial policies or any separate Medicare acknowledgment.

Practice Operations

We use information for scheduling, care coordination, quality review, staff training, record management, and other activities needed to operate our practice. For example, we may review treatment records to improve the care we provide.

Service Providers

We may share information with vendors that support these activities, such as our electronic medical record provider. Where required, we maintain business associate agreements that require safeguards and limit how these vendors may use your information.

Communication

We may contact you about appointments, treatment, care coordination, or billing using your recorded communication preferences. You may request a different communication method or location.

Family and Caregivers

Where permitted by law, we may share information relevant to a family member’s, caregiver’s, or designated person’s involvement in your care or payment. We consider your permission, objections, and recorded preferences. If you cannot express a choice, we may use professional judgment when permitted by law, including during emergencies or disaster relief.

Your Privacy Rights

Contact our privacy contact to exercise these rights. We can help you submit a request.

Access Your Records

You may ask to inspect or receive an electronic or paper copy of medical and billing information used to make decisions about you. We generally respond within 30 days. If a permitted extension is needed, we will explain it in writing. Any charge for copies will be reasonable, cost-based, and permitted by law. If access is denied, we will explain the reason and any available review rights.

Request a Correction

You may ask in writing to correct information you believe is inaccurate or incomplete and explain why. We generally respond within 60 days. We may deny a request when permitted by law, such as when the record is accurate and complete. We will explain a denial in writing and how you may submit a statement of disagreement.

Request Confidential Communication

You may ask us to contact you in a specific way or at a particular location. We will accommodate reasonable requests. You do not need to explain the reason.

Request Restrictions

You may request limits on how we use or share information for treatment, payment, or practice operations. We generally are not required to agree, but we will follow restrictions we accept, subject to lawful exceptions such as necessary emergency treatment.

If you pay privately for your services at the time of service, Achieve Wellness and Physical Therapy LLC assumes you are exercising your right to restrict disclosure of information relating to those services to your health plan, including Medicare, for payment or healthcare operations. We will not disclose your medical records to insurance companies for reimbursement purposes without your written authorization, except when disclosure is required by law. You may request a copy of your records and choose whether to provide them to your insurance company yourself.

Request an Accounting of Disclosures

You may request a list of certain disclosures made during the preceding six years. This generally excludes disclosures for treatment, payment, or healthcare operations; disclosures to you; and disclosures you authorized. The first accounting in a 12-month period is free. We will tell you in advance about any permitted fee for additional accountings.

Receive a Copy of This Notice

You may request a paper copy at any time, even if you received this notice electronically.

Use an Authorized Representative

A legally authorized personal representative may exercise your rights. We will verify that person’s authority and apply any exceptions required or permitted by law.

Ask Questions or File a Complaint

You may contact our privacy contact with questions or complaints. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights:

Website: https://www.hhs.gov/hipaa/filing-a-complaint/index.html
Phone: 1-877-696-6775
Address: 200 Independence Avenue SW, Washington, DC 20201

We will not retaliate against you for filing a complaint.

Other Disclosures Permitted or Required by Law

We may disclose information when applicable legal conditions are met for public health activities, reporting suspected abuse or neglect, preventing a serious threat to health or safety, health oversight, workers’ compensation, law enforcement, organ donation, coroners or medical examiners, funeral directors, or authorized government functions.

Research disclosures may occur only with your authorization or another lawful basis and required protections.

We may disclose information when required by law, including for government privacy compliance reviews. We evaluate court orders, subpoenas, and other legal requests for applicable privacy requirements before releasing information.

Information With Additional Legal Protection

We follow applicable Florida confidentiality requirements and other laws that provide greater protection than HIPAA. HIV test results, certain mental health information, and substance use disorder records may require additional consent or legal safeguards.

If we receive substance use disorder patient records protected by 42 CFR Part 2, we will not use or disclose those records in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a qualifying court order and subpoena.

If we use Part 2 information for fundraising communications, we will provide clear advance notice and a choice about receiving those communications. You may opt out of fundraising communications.

Uses Requiring Written Authorization

We obtain written authorization when required for marketing, sale of protected health information, most uses or disclosures of psychotherapy notes, and other uses or disclosures not permitted by this notice or applicable law.

We obtain separate written permission before using identifiable patient photos, videos, recordings, or testimonials for public advertising, social media, or promotional purposes. Acknowledging receipt of this notice does not grant that permission.

You may revoke an authorization in writing by contacting our privacy contact. Revocation stops future uses or disclosures covered by the authorization, except to the extent we have already acted in reliance on it. We cannot undo disclosures already made. You may receive a copy of your signed authorization.

Our Responsibilities

We safeguard your health information, follow the privacy practices described in this notice, and provide the privacy rights required by applicable law.

Where HIPAA applies, we are required by law to maintain the privacy and security of protected health information and notify you following a breach of unsecured protected health information as required by law. We also comply with other applicable privacy and breach notification laws.

Changes to This Notice

We may revise this notice and apply revised practices to information we already maintain, as permitted by law. The revised notice will show its effective date and will be available on our website and upon request. You may obtain the current notice from our privacy contact.