Patient Privacy & Confidentiality Notice
Effective Date: September 22, 2026
Last Updated: September 22, 2026
Revive Physical Therapy & Training LLC
3912 Slate Drive
Champaign, IL 61822
info@revivephysicaltherapyandtraining.com
(785) 341-5185
Our Commitment to Your Privacy
Revive Physical Therapy & Training LLC (“Revive,” “we,” “us,” or “our”) respects the privacy and confidentiality of information concerning your health and care.
We create and maintain records regarding physical therapy and other healthcare services provided to you. These records may include information regarding your health history, examination findings, physical therapy assessment, plan of care, treatment, progress, communications, billing, and other information related to your care.
Revive safeguards health information and uses or discloses it only as reasonably necessary to provide services, operate the practice, comply with applicable law and professional obligations, or as otherwise authorized by you.
Important Information About HIPAA
Revive is not a covered entity under the federal Health Insurance Portability and Accountability Act (“HIPAA”).
Accordingly, this document is not a HIPAA Notice of Privacy Practices.
Revive nevertheless recognizes the sensitive and confidential nature of patient health information and maintains administrative, technical, physical, and professional safeguards designed to protect that information in accordance with applicable law, professional standards, contractual obligations, and Revive's privacy practices.
How We May Use Your Health Information
Providing and Coordinating Your Care
We may use your health information to evaluate, treat, and manage your condition and to provide appropriate physical therapy or related services.
When permitted by applicable law, we may communicate information relevant to your care with another healthcare professional involved in your treatment, consultation, referral, or coordination of services.
We will limit such communications to information reasonably relevant to the purpose of the communication.
Practice Operations
We may use information as reasonably necessary to operate Revive, including for:
Maintaining clinical records;
Scheduling and appointment communications;
Quality improvement;
Administrative activities;
Business and legal compliance;
Secure electronic recordkeeping;
Payment processing and accounting;
Professional consultation when appropriate; and
Working with service providers that assist Revive in operating the practice.
We make reasonable efforts to limit access to patient health information to individuals and service providers who need the information for an appropriate purpose.
Payment and Superbills
Revive is a private-pay practice.
We may use health, billing, and contact information as reasonably necessary to collect payment for services, maintain financial records, and administer your account.
At your request, Revive may provide a superbill or other documentation that you may independently submit to an insurance company or other third party.
If you choose to submit a superbill or other records to an insurer or third party, information contained in those materials will be disclosed to that party at your direction.
Revive does not guarantee reimbursement or payment by any insurance company or other third party.
Uses or Disclosures Required or Permitted by Law
Revive may use or disclose health information when permitted or required by applicable state or federal law.
Depending on the circumstances, this may include matters involving:
Suspected abuse or neglect when reporting is legally required;
Serious threats to health or safety when disclosure is legally permitted or required;
Valid court orders, subpoenas, or other lawful legal process;
Professional licensing or regulatory investigations;
Workers' compensation matters when applicable;
Public-health reporting requirements; or
Other disclosures required or permitted by law.
When reasonably possible, Revive will limit a disclosure to information relevant to the permitted or required purpose.
Family Members, Friends, Coaches, Employers, Schools, and Other Third Parties
Revive will not routinely disclose your health information to family members, friends, coaches, employers, trainers, schools, athletic organizations, or other third parties without your permission or the permission of your legally authorized representative, except when disclosure is otherwise permitted or required by law.
When ongoing communication with another person or organization is appropriate, Revive may ask you to complete a written authorization identifying:
The person or organization that may receive the information;
The information that may be shared;
The purpose of the communication; and
The duration of the authorization.
You may revoke an authorization as provided in the authorization and applicable law.
Signing an authorization allowing disclosure to a third party is voluntary and ordinarily will not be required as a condition of receiving physical therapy services unless the disclosure is otherwise necessary or permitted by law for the services involved.
Minor Patients
For minor patients, a parent, legal guardian, or other legally authorized representative generally may make healthcare decisions and exercise applicable rights on behalf of the minor.
Certain circumstances may be governed by specific state or federal laws that permit a minor to consent to particular healthcare services or that provide additional confidentiality protections for certain information.
Revive will follow applicable law in those circumstances.
Access to Your Records
You or your legally authorized representative may request access to or copies of your healthcare records as provided by applicable Illinois law.
Requests for records should be made in writing and sent to:
Revive Physical Therapy & Training LLC
Email: info@revivephysicaltherapyandtraining.com
Revive will respond to requests within the time required by applicable law and may charge copying, delivery, or other fees only when permitted by law.
Certain information may be subject to limitations or exceptions under applicable law.
Requests to Correct Information
If you believe information contained in your Revive record is inaccurate or incomplete, you may contact us and ask that the information be reviewed.
When appropriate, Revive may supplement, clarify, or correct information while maintaining the integrity of the original clinical record as required by applicable professional and legal standards.
Confidential Communications
You may ask Revive to communicate with you using a particular telephone number, email address, mailing address, or other reasonable communication method.
Please notify us if you have specific privacy preferences regarding communications.
We will make reasonable efforts to accommodate appropriate communication preferences.
Electronic Communications
Revive may communicate with patients and their authorized representatives electronically, including through:
Secure patient portals;
Email;
Telephone; and
Text messaging.
Electronic communications can carry privacy and security risks.
Revive uses reasonable safeguards when communicating health information electronically. However, ordinary email and text messaging cannot be guaranteed to be completely secure.
Please notify Revive if you prefer that certain information not be communicated through a particular method.
Service Providers and Electronic Systems
Revive uses third-party services to assist with practice operations, including electronic recordkeeping, scheduling, communications, billing, and payment processing.
These providers may receive or maintain information when necessary to perform services for Revive.
Revive seeks to use service providers and systems appropriate for the information involved and limits information disclosed to service providers to what is reasonably necessary for the services they perform, subject to applicable law and contractual arrangements.
Security of Your Information
Revive uses reasonable administrative, technical, and physical safeguards designed to protect personal and health information against unauthorized access, use, loss, alteration, or disclosure.
No electronic system, storage method, communication method, or security measure can be guaranteed to prevent every unauthorized access or security incident.
If Revive becomes aware of a security incident involving personal or health information, we will investigate and take appropriate responsive measures. We will provide notification to affected individuals or governmental authorities when required by applicable law.
Specially Protected Information
Certain types of information may receive additional protection under Illinois or federal law.
Depending on the circumstances, this may include certain information relating to:
Mental-health treatment;
Substance-use-disorder treatment;
HIV/AIDS testing or treatment;
Genetic testing or genetic information; or
Other categories of information afforded heightened confidentiality protection by law.
When such requirements apply, Revive will comply with applicable consent, authorization, disclosure, and confidentiality requirements.
Website Privacy
This Patient Privacy & Confidentiality Notice addresses information associated with patient care and Revive's clinical operations.
Information collected through Revive's public Website is also addressed in our separate Website Privacy Policy, available at:
www.revivephysicaltherapyandtraining.com
Questions, Concerns, or Privacy Requests
If you have questions regarding how Revive uses, maintains, protects, or discloses your health information, or if you believe your information has been handled improperly, please contact:
Privacy Contact
Revive Physical Therapy & Training LLC
3912 Slate Drive
Champaign, IL 61822
Email: info@revivephysicaltherapyandtraining.com
Phone: (785) 341-5185
Revive will not retaliate against you for asking a question, making a privacy request, or raising a good-faith concern regarding the handling of your information.
Changes to This Notice
Revive may update this Patient Privacy & Confidentiality Notice as our practices, technology, services, or legal obligations change.
The current version will be available through Revive and may also be posted electronically on our Website.
The Last Updated date at the top of this Notice identifies the most recent revision.
Acknowledgment of Receipt
Patients may be asked to acknowledge that they have received or been given access to this Patient Privacy & Confidentiality Notice as part of Revive's intake process.
An acknowledgment confirms receipt of or access to this Notice. It does not authorize Revive to disclose your health information to third parties beyond disclosures otherwise permitted by applicable law or separately authorized by you.