Protected Health Information & Privacy Policies
Protected Health Information (PHI)
Effective Date: 1/6/2026
This Notice describes how Forged Physical Therapy and Performance may use and disclose your protected health information (PHI) and explains your rights under the Health Insurance Portability and Accountability Act (HIPAA) and North Carolina law. Please review it carefully.
Our Legal Duties
We are required by law to:
Maintain the privacy of your PHI
Provide you with this Notice
Follow the terms of this Notice currently in effect
How We May Use and Disclose Your PHI:
Treatment
We may use and share your PHI to provide and coordinate your physical therapy care.
Payment
As a cash-based practice, we use PHI to collect payment directly from you. With your authorization, we may provide documentation for insurance reimbursement or health savings accounts.
Healthcare Operations
We may use PHI for practice operations such as scheduling, quality improvement, and administrative activities.
Virtual Services
If you participate in virtual rehab coaching or performance training services, your PHI may be communicated electronically using secure platforms. Despite safeguards, electronic communication carries some risk.
As Required by Law
We may disclose PHI when required by federal or North Carolina law, including public health reporting or to prevent serious threats to health or safety.
Uses Requiring Your Authorization
We will obtain your written authorization before using or disclosing your PHI for purposes not listed above, including marketing or release to third parties not involved in your care. You may revoke authorization in writing at any time.
Your Rights
You have the right to:
Access your health records
Request corrections to inaccurate or incomplete information
Request restrictions on certain uses or disclosures (not all requests must be granted)
Request confidential communication methods
Receive an accounting of disclosures
Obtain a copy of this Notice at any time
Breach Notification
You will be notified if a breach occurs that compromises the privacy or security of your unsecured PHI, as required by law.
Changes to This Notice
We may update this Notice at any time. Changes will apply to all PHI we maintain and will be available upon request or on our website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Forged Physical Therapy and Performance, or
The U.S. Department of Health and Human Services (HHS)
You will not be retaliated against for filing a complaint.
Contact Information
Privacy Officer: Jordan Pittman
Business Name: Forged Physical Therapy and Performance
Email: jpittman@forgedptperformance.com
Address: 1372 N Main Street, Fuquay Varina, NC 27526