OSSPT HIPAA Information

On-Site Solutions Physical Therapy takes the privacy and security of our patients PHI (Protected Health Information) very seriously. We make every effort to ensure your personal information stays safe and secure. Please read our Notice of Privacy Practices for more information on how we may utilize your information.

For more information on all aspects of HIPAA including records access, restricting information or general questions, please contact Steve Ahlvers, HIPAA Officer, using the form below.

For Privacy Policy Acknowledgement or to Request Records, see the form below the corresponding Policy below.

Notice of Privacy Practices: updated 1/2024

Notice of Privacy Practices Acknowledgement

Acknowledgement of HIPAA Privacy Notice

Authorization for the Release of Information

Release of Information

Amendment Request Form

Access Request Form

Alternative Communications Form

Restriction Request Form

Accounting of Disclosures Form

Complaint Form

Records Requests Costs

The Health Information Portability and Accountability Act of 1996 allows for companies to recover costs associated with reproducing records. The following are the charges On-Site Solutions Physical Therapy implements when providing records:

Records Request TypeCost
​Obtaining own records for a current course of care (must be sent to a provider)Free
Viewing of own recordsFree
Obtaining personal records for own use$10 retrieval fee plus
​$0.75 per page
Obtaining records for other personal use$10 retrieval fee plus
​$0.75 per page
Records requested from anyone other than patient$10 retrieval fee plus
​$0.75 per page