CANCELLATION POLICY

In-person sessions at PhysioStrength are by made by appointment only; as such if a patient cancels without giving sufficient notice, it unfortunately prevents another patient from being seen. If you need to cancel your appointment, please do so at least 24 hours in advance through the cancellation link provided in your confirmation email OR by emailing your physical therapist at Clinton@physiostrengthnyc.com or Jordan@physiostrengthnyc.com.

If 24 hour notice is not provided or if the patient does not appear for their appointment as scheduled, a $100.00 cancellation fee will be charged for the missed appointment.

I have read, understood and agree to the above terms:

NOTICE OF PATIENT PRIVACY PRACTICES
(FYI)

According to the Health Insurance Portability and Accountability Act, known as HIPAA, physical, occupational and speech therapists in private practices must incorporate the federal privacy standards to protect patient’s medical records and other health information provided to health plans, doctors, hospitals and other health care providers.  Please note that Dr. Clinton Lee, PT, DPT/Clinton Lee Physical Therapy, LLC/PhysioStrength may use your personal health information for treatment, obtaining payment, during an audit, in emergencies, or when required by law. You will be asked for written authorization to use their personal medical information for any other reason than those listed above.  You have the right to review their personal health information at any time, to request that inaccurate information be corrected, or to request a list of instances when the information has been disclosed for reasons other than treatment, payment or other administrative purposes. You have the right to restrict how the information is used and disclosed for treatment, payment and administrative operations. The requests for restrictions will be considered on a case-by-case basis.  You have the right to address concerns and complaints about a potential violation of their health privacy to the US Department of Health and Human Services.

For further questions, you may contact the Compliance Officer:

Dr. Clinton Lee, PT, DPT
580 Broadway, Suite 403
New York, NY 10012