Privacy Policy & Legal Information

Effective Date: April 12, 2026

NOTICE OF PRIVACY PRACTICES

This notice describes how medical information about you may be used and disclosed and how you can access this information.

1. Our Commitment to Your Privacy

• Maintain the privacy of your PHI
• Provide this notice
• Follow its terms

2. How We Use and Disclose Information

Treatment: Coordinate your care with healthcare providers.

Payment: Bill insurance, verify eligibility, collect payments.

Operations: Improve clinic services and quality.

3. Additional Uses

• Required by law
• Public health and safety
• Workers’ compensation
• Legal proceedings

4. Your Rights

• Access and copies of records
• Request corrections
• Request restrictions
• Confidential communication
• Disclosure list
• File complaints

5. Our Responsibilities

• Protect your PHI
• Notify breaches
• No unauthorized disclosures

6. Contact Information

Move Forward Physical Therapy & Wellness
2008 New Garden Road, Suite D
Greensboro, NC 27410
Phone: 336-252-8852
Email: info@moveforward-pt.com

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TERMS & CONDITIONS + PATIENT FINANCIAL POLICY

1. Acceptance of Terms

By receiving services, you agree to these terms.

2. Nature of Services

• Physical therapy
• Rehabilitation
• Manual therapy
• Therapeutic exercise
• Dry needling

3. Dry Needling Consent

• Soreness or bruising
• Minor bleeding
• Dizziness
• Rare infection
• Very rare pneumothorax

4. Appointments & Cancellations

• 24-hour notice required
• $25 fee for no-shows

5. Payment Policy

Insurance: We bill as courtesy. You pay co-pays, deductibles.

Cash: Payment due at time of service.

Out-of-network: Superbills available.

6. Patient Responsibilities

• Provide accurate information
• Follow treatment plan
• Report condition changes

7. Liability

Not liable except for gross negligence.

8. Governing Law

North Carolina law applies.

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WEBSITE PRIVACY POLICY

1. Information We Collect

• Name, phone, email
• Appointment requests
• Health-related info
• Analytics data

2. How We Use Information

• Schedule appointments
• Communicate with patients
• Improve services

3. HIPAA & Online Communication

Forms/email may not be fully secure. Avoid sensitive data unless instructed.

4. Cookies

We may use cookies and analytics tools.

5. Third-Party Services

We use scheduling, payment, and email providers.

6. Data Sharing

No selling of data. Shared only when necessary or legally required.

7. Your Rights

• Access or correct information
• Opt out of communications

8. Security

We use safeguards but cannot guarantee 100% security.

9. Children's Privacy

Not intended for children under 13.

10. Changes

Policy may be updated periodically.

11. Contact

Email: info@moveforward-pt.com
Phone: 336-252-8852