Seattle Massage Pro
Phone: (206) 909-2994
Fax: (206) 922-2053
Claim #:
Notice of Privacy Practice (HIPAA)
All Licensed Massage Practitioners (known as LMP’s) at Seattle Massage Pro are expected to follow appropriate professional standards for maintaining client confidentiality. Seattle Massage Pro is a health care provider and it will use or disclose health information for treatment, billing, and healthcare operation as dictated by the Health Insurance Portability and Accountability Act, known as HIPAA. You have the right to request restriction on uses and disclosures of your health information for treatment, payment and health care operations.
Privacy Practice
Seattle Massage Pro retains client records. LMP’s use client records when providing massage services to individual clients for the safety and consistency of treatment. Client records may be discussed and reviewed by Seattle Massage Pro staff for insurance purposes or treatment planning. Client records are maintained in a confidential manner, in a file folder, which is to be secured in a locked file when not in use by the LMP or being reviewed for administrative purposes. Clients may request in writing to see or obtain a copy of their records. The client may request that corrections be made if they identify errors or mistakes. Requested records are sent either standard US Mail, encrypted HIPAA-compliant email, in person, or fax, unless the client requests they are sent via express mail and agree to pay the express shipping fees. At no time are client records and information released to anyone outside of Seattle Massage Pro without written request and release from the client unless compelled by law such as a subpoena or for insurance billing.
Seattle Massage Pro uses a secure encrypted HIPAA-compliant email account for correspondence of personal information. Personal information may include details of a massage, insurance information, health history, medical records, or scheduling information. Seattle Massage Pro is not responsible for the privacy of information you send or receive from your non-secure account. Online scheduling email confirmations and 24hour email reminders are not sent from a HIPAA-compliant email, and therefore may be at privacy risk. By scheduling online, the client is acknowledging and agreeing to receive the confirmation of their appointment information from the scheduling service (Genbook). Seattle Massage Pro does not share any of this information with anyone.
By checking this box, I acknowledge and agree that Seattle Massage Pro maycorrespond via email. I choose to take full responsibility of the security of my personal data when sending or receiving it from a non-secure email account or viewing from a public computer.
Texts, voicemail,and mobile phones
Texts and voicemail on mobile phones are not secure and therefore written consent is needed before Seattle Massage Pro may correspond regarding private information via text or voicemail.
By checking this box I am agreeing to receive texts or voice messages from Seattle Massage Pro on my phone.
Acknowledgment of Receipt of Notice
I (print full name) ______have received, read, and understand this privacy policy as it relates to receiving massage therapy from Seattle Massage Pro.
Client Signature: ______Date: ______