Statement of Privacy Notice
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We may disclose your health care information to other healthcare professionals within our practice for the purpose of treatment, payment or healthcare operations.
We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your care about your medical condition or in the event of an emergency or of your death.
As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.
We may disclose your health information in the course of any administrative or judicial proceeding.
We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and other law enforcement purposes.
We may disclose your health information to coroners or medical examiners.
We may disclose your health information to organizations involved in procuring, banking, or transplanting organs and tissues.
We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board.
It may be necessary to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or to the general public.
We may disclose your health information for military, national security, prisoner and government benefits purposes.
We may leave a message on an automated answering device or person answering the phone for the purposes of scheduling appointments. No personal health information will be disclosed during this recording or message other than the date and time of your scheduled appointment along with a request to call our office if you need to cancel or reschedule your appointment.”
We may contact you or send your bill by phone, mail, or email. “It is our practice to participate in charitable and marketing events to raise awareness, food donations, gifts, money, etc. During these times, we may send you a letter, post card, invitation or call your home to invite you to participate in the charitable activity.
We may disclose your health information to your insurance provider for the purpose of payment or health care operations.
We may disclose your health information as necessary to comply with State Workers’ Compensation Laws.
In the event that we are sold or merged with another organization, your health information/record will become the property of the new owner.
! You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that we are not required to agree to the restriction that you requested.
- You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request.
- You have the right to inspect and copy your health information.
- You have a right to request that we amend your protected health information. Please be advised, however, that we are not required to agree to amend your protected health information. If your request to amend your health information has been denied, you will be provided with an explanation of our denial reason(s) and information about how you can disagree with the denial.
- You have a right to receive an accounting of disclosures of your protected health information made by us.
- You have a right to a paper copy of this Notice of Privacy Practices at any time upon request.
We reserve the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment is made, we are required by law to comply with this Notice.
We are required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. If you have questions about any part of this notice or if you want more information about your privacy rights, please contact us by calling this office at (949) 236-6862. If our Privacy Officer is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days.
Complaints about your Privacy rights, or how we have handled your health information should be directed to our Privacy Officer by calling this office at (949) 236-6862. If our Privacy Officer is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days.
If you are not satisfied with the manner in which this office handles your complaint, you may submit a formal complaint to:
DHHS, Office of Civil Rights
200 Independence Avenue, S.W. Room 509F HHH Building Washington, DC 20201
I have read the Privacy Notice and understand my rights contained in the notice.
By way of my signature, I provide the company above with my authorization and consent to use and disclose my protected health care information for the purposes of treatment, payment and health care operations as described in the Privacy Notice
By signing below, you give the us permission to perform the evaluation and treatment recommendations. You have the right to accept or refuse any treatment offered. There are no guarantees made as to the results that may be obtained from our treatment(s). We will do our best to provide a treatment/exercise program that causes the least amount of pain to you. It is your responsibility to accurate information to get the best recommendation from our system . If you have any questions about your care, be sure to ask the chat or call us.
It is up to you(patient)/caretaker to inform the our system or staff about any health problems or allergies you may have. You, the patient or the caretaker must also tell the software /staff about drugs or medications being taken as well as any medical conditions and/or surgeries.
Minors and Parents
If patient is a minor (under 18 years of age), the parent or legal guardian is responsible for all charges and decisions made by the minor. We do not assume any liability for the minor while on premises or not, and it is the responsibility of the parent or guardian to supervise the minor before, during and after treatments.
Consent To Participate In Research Study
I Agree to participate in a research study conducted by ASTR institute and its affiliates. My participation in this study is voluntary. I have read the information below and have asked questions regarding anything I do not understand and have decided to participate in the study/research. I further authorize the said parties to use my medical information in their literature.
My participation in this research study will help others have a better understanding of the effects of ASTR Institute on patients. ASTR Institute will not use my name, address or phone number in this study/research.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Results may vary with each person and we cannot guarantee that you will experience the same results found in our testimonial and treatment videos. Each individual is different and one person’s success is not a guaranteed result. These products are not intended to diagnose, cure, treat or prevent any disease.
The videos & website information are not intended to provide diagnosis, treatments, opinions, services or advice to any viewers. Through our social media, courses and website we introduce you to new ideas for treatment, intended to be researched and expand general knowledge. The content in our website, any videos or social media posts can not be substituted for professional assistance. If you are concerned over a medical issue, please consult your healthcare provider, physician, or other medical professional.
Dr. Joseph Jacobs and ASTR institute are in no way responsible or liable for any actions, services or products acquired through this website, our videos, or social media posts. ASTR institute nor its associated organizations or people are not responsible for any injury or harm caused by the application of information in our courses, website and social media post. It is recommended that you review your questions and/or concerns with a medical professional. Use our information at your own risk. The content on our courses, website, social media posts cannot be substituted for professional assistance. If you are concerned about a medical issue, please consult your healthcare provider, physician, or other medical professional.
ASTR institute and ASTR courses are intended as advanced training for healthcare providers and physicians. These courses alone do not confer upon an unlicensed practitioner the legal authority to implement the information in these courses upon patients or clients. Some of the information in these courses may be beyond the scope of a private practice of healthcare who is not licensed as, or supervised by a physician, or other appropriately licensed practitioner. Before utilizing the information or techniques presented in these courses on patients or clients, an unlicensed practitioner, or a practitioner with a restrictive license (such as a pharmacist, physical therapist, occupational therapist, chiropractor, nurse, dietician, etc) should check with the relevant practice acts in his/her state to ensure that the practitioner’s use of the modalities, therapies, or techniques set forth in these courses is consistent with state law.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. The content on our courses cannot be substituted for professional assistance. If you are concerned about a medical issue, please consult your healthcare provider, physician, or other medical professional. Dr. Joseph Jacobs and ASTR institute are in no way responsible or liable for any actions, services or products acquired through this website. ASTR institute and its associated organizations or people are not responsible for any injury or harm caused by the application of ASTR tools. ASTR tools are generally safe when practiced with proper technique and care. It is recommended that you review your questions and/or concerns with a medical professional. Stop using immediately if painful or conditions worsen. Use at your own risk.
Collection of your Personal Information
ASTR institute may collect personally identifiable information, such as your name. If you purchase Advanced Soft Tissue Release’s products and services, we collect billing and credit card information. This information is used to complete the purchase transaction. We may gather additional personal or non-personal information in the future.
Information about your computer hardware and software may be automatically collected by Advanced Soft Tissue Release. This information can include: your IP address, browser type, domain names, access times and referring website addresses. This information is used for the operation of the service, to maintain quality of the service, and to provide general statistics regarding use of the ASTR institute website.
ASTR institute encourages you to review the privacy statements of websites you choose to link to from Advanced Soft Tissue Release so that you can understand how those websites collect, use and share your information. ASTR institute is not responsible for the privacy statements or other content on websites outside of the Advanced Soft Tissue Release website.
Use of your Personal Information
ASTR institute collects and uses your personal information to operate its website(s) and deliver the services you have requested.
ASTR institute may also use your personally identifiable information to inform you of other products or services available from ASTR institute and its affiliates. Advanced Soft Tissue Release may also contact you via surveys to conduct research about your opinion of current services or of potential new services that may be offered.
ASTR institute (Advanced Soft Tissue Release) does not sell, rent or lease its customer lists to third parties.
ASTR institute may, from time to time, contact you on behalf of external business partners about a particular offering that may be of interest to you. In those cases, your unique personally identifiable information (e-mail, name, address, telephone number) is not transferred to the third party. Advanced Soft Tissue Release may share data with trusted partners to help perform statistical analysis, send you email or postal mail, provide customer support, or arrange for deliveries. All such third parties are prohibited from using your personal information except to provide these services to ASTR institute, and they are required to maintain the confidentiality of your information.
ASTR institute may keep track of the websites and pages our users visit within Advanced Soft Tissue Release, in order to determine what ASTR institute services are the most popular. This data is used to deliver customized content and advertising within ASTR institute to customers whose behavior indicates that they are interested in a particular subject area.
ASTR institute will disclose your personal information, without notice, only if required to do so by law or in the good faith belief that such action is necessary to: (a) conform to the edicts of the law or comply with legal process served on Advanced Soft Tissue Release or the site; (b) protect and defend the rights or property of Advanced Soft Tissue Release; and, (c) act under exigent circumstances to protect the personal safety of users of Advanced Soft Tissue Release, or the public.
The ASTR institute website may use “cookies” to help you personalize your online experience. A cookie is a text file that is placed on your hard disk by a web page server. Cookies cannot be used to run programs or deliver viruses to your computer. Cookies are uniquely assigned to you, and can only be read by a web server in the domain that issued the cookie to you.
One of the primary purposes of cookies is to provide a convenience feature to save you time. The purpose of a cookie is to tell the Web server that you have returned to a specific page. For example, if you personalize Advanced Soft Tissue Release pages, or register with Advanced Soft Tissue Release site or services, a cookie helps Advanced Soft Tissue Release to recall your specific information on subsequent visits. This simplifies the process of recording your personal information, such as billing addresses, shipping addresses, and so on. When you return to the same Advanced Soft Tissue Release website, the information you previously provided can be retrieved, so you can easily use the Advanced Soft Tissue Release features that you customized.
You have the ability to accept or decline cookies. Most Web browsers automatically accept cookies, but you can usually modify your browser setting to decline cookies if you prefer. If you choose to decline cookies, you may not be able to fully experience the interactive features of the Advanced Soft Tissue Release services or websites you visit.
Security of your Personal Information
ASTR institute secures your personal information from unauthorized access, use or disclosure.
Children Under Thirteen
ASTR institute does not knowingly collect personally identifiable information from children under the age of thirteen. If you are under the age of thirteen, you must ask your parent or guardian for permission to use this website.
Opt-Out & Unsubscribe
We respect your privacy and give you an opportunity to opt-out of receiving announcements of certain information. Users may opt-out of receiving any or all communications from ASTR institute by contacting us here:
– Web page: https://advancedsofttissuerelease.com/contact-page/
– Email: firstname.lastname@example.org
– Phone: (949) 236- 6862
Changes to this Statement
ASTR institute will occasionally update this Statement of Privacy to reflect company and customer feedback. ASTR institute encourages you to periodically review this Statement to be informed of how Advanced Soft Tissue Release is protecting your information.
ASTR institute welcomes your questions or comments regarding this Statement of Privacy. If you believe that ASTR institute has not adhered to this Statement, please contact ASTR institute at:
Telephone number: 888-210-2787
Effective as of December 20, 2018