Policies

Consuming medically supervised digital neutral spine conditioning services for long-term injury management and injury prevention from the comfort of your home requires a few guidelines.

PT on Demand is the exclusive distributor of the Healthy Posture System video library. The Healthy Posture System combines 9 levels of neutral spine conditioning with proprietary joint clearing techniques to help restore movement from healthy posture. PT on Demand is a telehealth platform that distributes the Healthy Posture System's video content through telehealth coaching sessions for those with active injuries. The program is safe for anyone to complete that does not have an active injury. It is safe to complete with medical supervision for most active pain conditions that do not require surgery.

Our Prehab programs are safe and powerful compliment to any upcoming surgery or medical procedure but require a tele-PT screen to ensure appropriateness even if prescribed by your physician.

We require that everyone aspiring to use the product to treat the foundation of their pain or for any other motivation to complete a telehealth PT screening to ensure the video content is appropriate for your needs and best match your goals. The purchase of a Tele-PT Screening requires that your agree to all the policies below.

Service Agreement

PT on Demand is the exclusive distributor of the Healthy Posture System. PT on Demand provides telehealth physical therapy coaching services for those with an active injury to help them safely perform the exercises within the Healthy Posture System. The goal of the program is to help each client condition themselves to perform their daily activities from neutral spine alignment. PT on Demand also provides neutral spine conditioning coaching services for those without an active injury to achieve the same objective for injury prevention-oriented care.

PT on Demand provides clients in states where PT on Demand has appropriately licensed personnel (“PT Service States”)* with access to the patent-pending Healthy Posture System video-on-demand library to clients who have an active injury or who have an upcoming medical procedure to assist them in breaking the faulty loading patterns that could be contributing to their pain. PT on Demand also provides clients in PT Service States synchronous telehealth physical therapy sessions to ensure that conditioning exercises are performed safely, correctly, and from a neutral spine alignment. The PT on Demand telehealth sessions are administered by a Licensed Physical Therapist, Licensed Physical Therapy Assistant, or other equivalent medically licensed rehabilitation specialist authorized to provide physical therapy services in the PT Service States. PT on Demand telehealth sessions are intended to help clients restore their ability to perform the functions of daily life by ensuring proper posture and establishing a healthy foundation for long-term healing and physical health. Access to the PT on Demand video-on-demand library and telehealth sessions requires an active PT on Demand subscription package.

*Current PT Service States: Colorado, Florida

Use of the term “physical therapist” throughout this intake form means a Licensed Physical Therapist, Licensed Physical Therapy Assistant, or other equivalent medically licensed rehabilitation specialist if authorized under PT Service State law to provide the services contemplated herein.

PT on Demand does not market it services outside of states it does not have an licensed physical therapist that can provide telehealth physical therapy services consistent with the laws and regulations of that state. We do market our products to physician groups who may prescribed the Healthy Posture System as a compliment to their services. Those reporting an active injury that reside in any state other than Current PT Service States can still complete the Healthy Posture System without physical therapy supervision at their own risk. By signing this form, you are agreeing to complete the program self-guided. Online coaching services can be provided to make sure you are safe to progress to the next level of the program by PT on Demand certified staff that may or may not have a medical license.

Policies

PT ON DEMAND POLICIES AND INFORMATION

1. Screening by a Licensed Practitioner. Prior to starting the PT on Demand program, you will be asked to participate in an Initial Health Screening with a licensed Physical Therapist or other equivalent medically licensed rehabilitation specialist. If you undergo an Initial Health Screening, more information will be gathered from you at that time. Additionally, if you sustain any injury, regardless of the cause or nature of the injury, during the time you are participating in the PT on Demand program, you will be required to undergo an Injury Severity Screening with a licensed Physical Therapist other equivalent medically licensed rehabilitation specialist. If you undergo an Injury Severity Screening, more information will be gathered from you at that time to identify what modifications to your current fitness program are needed to ensure safety.

2. Telehealth Session Access. To access and attend PT on Demand telehealth sessions, you must have an active internet connection and a mobile device (such as a phone or tablet), a laptop, or a desktop computer that can access the internet. All PT on Demand telehealth sessions are conducted through the Microsoft Teams software. A Microsoft Teams account is NOT required to attend a telehealth session. Access to the PT on Demand telehealth sessions requires an active PT on Demand subscription.

3. Healthy Posture System Video-On-Demand Subscription. In conjunction with PT on Demand, clients have access to the Healthy Posture System video-on-demand service, provided and managed through Vimeo, a third-party vendor. Access to Vimeo and the Healthy Posture System video-on-demand services is conditioned on your acceptance of and compliance with the policies in this Intake Form and any other rules that PT on Demand may publish from time to time. Access to the Healthy Posture System video-on-demand service requires an active PT on Demand subscription. You are solely responsible for creating and managing your Vimeo account and Vimeo subscription. PT on Demand is not a party to and shall not be held liable for the purchase, suspension, termination, or any other action taken in regards to your Vimeo account or subscription.

4. Payment. You are financially responsible for all charges related to services provided to you as part of the Healthy Posture System and the PT on Demand program. You will be billed separately for Healthy Posture System video access and the PT on Demand telehealth services, as detailed below:

a. Video-on-Demand Subscription. Vimeo will bill you directly for Vimeo subscription that you will use to access the Healthy Posture System video-on-demand library. Your Vimeo subscription is a 30-day subscription unless otherwise described by Vimeo. Your Vimeo subscription will automatically renew each month until you cancel the subscription.

b. PT on Demand Telehealth Services. PT on Demand will bill you for telehealth physical therapy services through Mindbody Online. The amount of this bill will vary depending on the frequency of your telehealth sessions and the services provided. You will be automatically enrolled in an automatic payment plan for the telehealth services. PT on Demand reserves the right to change its billing terms at any time.

5. Telehealth Session Procedure and Safety Information. All video-on-demand workout videos are password protected. You will be told the password and granted access to your prescribed video-on-demand video(s) prior to each telehealth session. You are expected to watch the next workout in the video-on-demand que unless directed otherwise by your physical therapist. You are expected to have all the necessary exercise equipment available and set up prior to your scheduled online telehealth session. Your physical therapist will work with you to create a program that is tailored to your skill level and demonstrated fitness abilities. Your physical therapist will assign you a fitness ability level. The PT on Demand program may contain some or all of the video-on-demand exercise videos at your assigned fitness ability level. Your physical therapist will provide you with detailed instructions during your telehealth session. Your participation in telehealth physical therapy sessions is at your own risk.

6. Discharge From PT on Demand. The PT on Demand program is intended for use only by clients who are managing an active injury and/or are preparing for an upcoming medical procedure. When your physical therapist has determined that you are no longer managing an active injury, preparing for or rehabilitating from a medical procedure, or have otherwise progressed to a physical condition where PT on Demand services are no longer necessary, you will be discharged from the PT on Demand program. Your discharge from the PT on Demand program ends your relationship with PT on Demand. However, if you wish to continue to access the Healthy Posture System video-on-demand services and to receive additional online exercise coaching at a fitness and conditioning level upon your discharge from PT on Demand, you can enroll in the Healthy Posture Club. The Healthy Posture Club does not provide physical therapy, does not treat, prevent, or otherwise rehabilitate any disease or other health condition, and is not a physical therapy regiment. You will be provided with additional information about enrollment in the Healthy Posture Club program at the time of your discharge from PT on Demand.

7. Recording and Documentation. All telehealth sessions may be video recorded, subject to your physical therapist’s approval, to serve as an additional resource. You must request to video record the telehealth session at the start of each session. Your physical therapist can, upon request, generate a quarterly progress summary report for you to summarize your PT on Demand program progress. This summary report will list the dates of each telehealth session, the workout completed and any remarkable observations associated with each workout.

8. Cancellation and Refund Policy. You may cancel a scheduled telehealth session at any time. However, you will be charged the full cost of any telehealth session not cancelled with at least 24 hours’ notice. Your PT on Demand subscription can be cancelled by providing PT on Demand with a notice of cancellation at least two weeks prior to the subscription’s renewal date. You must cancel your Vimeo subscription with Vimeo directly. There are no refunds for unused video-on-demand subscription or telehealth services, provided, however, as noted in Section 6 above, fees for unused telehealth services will be credited to a Healthy Posture Club subscription. Unused video-on-demand or telehealth sessions from a previous month cannot be transferred to any subsequent month.

9. Mandatory Disclosure of Injury. You are responsible for disclosing any injury you have sustained, regardless of the cause or nature of the injury, to your physical therapist prior to your telehealth session. In the event you sustain an injury that, in your opinion or experience, limits your functional mobility in any way, you are advised to cease participating in the video-on-demand services until you have been evaluated in person or via telehealth in order to adjust exercises as necessary until the injury has resolved.

10. Video Usage Disclaimer. All Healthy Posture System audiovisual content is for private, individual use only. The unauthorized reproduction, editing, exhibition, distribution, renting, exchanging, hiring, lending, public performance, diffusion and/or broadcasting of this copyrighted work, or any portion thereof, is strictly prohibited. This video content is not to be exported, distributed, and/or sold by way of trade without a proper license from Healthy Posture Club. The instructional information included in any video-on-demand shall not be stored or used on a computer except for personal use. Any of the foregoing activities establish liability for a civil action and may give rise to criminal prosecution. The name "PT on Demand" and logo may not be used in any manner or for any purpose without the express written consent of PT on Demand. All video content is proprietary to Healthy Posture Club or PT on Demand. PT on Demand utilizes the patent-pending Healthy Posture System as its exclusive movement education system for participants in its video-on-demand and physical therapy telehealth program. PT on Demand shall not be liable for use of the Healthy Posture System; clients participate at their own risk. PT on Demand shall not be liable for any delays, inaccuracies, errors, or omissions set forth in any video content or in the transmission or delivery of all or any part thereof.

11. Electronic and Telehealth Services. The Healthy Posture System and PT on Demand video-on-demand and telehealth program are provided solely through asynchronous videos and synchronous, audio-visual telecommunications calls with your physical therapist.

12. PT on Demand Services Limited to Residents of PT Service States. PT on Demand telehealth program services are only available to and may only be accessed by clients currently residing in a PT Service State.

Consent to Participate Waiver

1. I understand that it is solely my responsibility to inform PT on Demand and my physical therapist of any injuries or other changes to my health that could impact my participation in the Healthy Posture System and/or the PT on Demand video-on-demand and telehealth program and I understand that PT on Demand shall not be liable should I fail to do so.

2. I have read and understand the PT on Demand Intake Form and all PT on Demand Policies and Information. I understand that this Intake Form and Policies are applicable to all services I receive through PT on Demand and consent to all terms contained therein.

3. I have been provided with a copy of the PT on Demand Notice of Privacy Practices. I have read and understood this Notice and how it relates to my personal information.

4. I understand that I am financially responsible for all services provided to me by PT on Demand, which includes but is not limited to the Healthy Posture System and the video-on-demand and telehealth program. All questions regarding fees, payment, and billing should be asked prior to the provision of services.

5. I understand that the PT on Demand video-on-demand and telehealth program is a telehealth physical therapy service and I consent to the provision of such services through synchronous audio-visual telehealth visits. I understand that the Healthy Posture System video-on-demand program is available solely through Vimeo, an asynchronous telecommunication platform, and I consent to the telecommunications provision of these services and videos.

6. I understand that PT on Demand provides Physical Therapy services to clients residing in a PT Service States, and I affirm that I am a resident of a PT Service State.

7. I consent to and authorize PT on Demand to administer physical therapy treatment under the direction and supervision of a Licensed Physical Therapist or other equivalent medically licensed rehabilitation specialist if so allowed by PT Service State law. I understand and am informed that physical therapy may have some risks. I understand that I have the right to ask about these risks and have any questions about my condition(s) answered prior to treatment. I understand that it is my responsibility to inform PT on Demand of any health problems or conditions I have as well as any medications I am taking prior to beginning the PT on Demand program, and I understand that it is my responsibility to inform PT on Demand of any changes to my health status, allergies, or medications.

8. I understand that the Healthy Posture System and the PT on Demand video-on-demand and telehealth program may involve physically strenuous activity and I voluntary participate in the Healthy Posture System and/or the PT on Demand video-on-demand and telehealth program with full knowledge that there is the risk of personal injury, property loss, or death. The services provided as part of the PT on Demand program, and my use of equipment as part of the PT on Demand program, have inherent risks, dangers, and hazards. My participation in such services and/or use of such equipment may result in injury or illness including, but not limited to, bodily injury, disease, strains, fractures, partial and/or total paralysis, death, or other ailments that could cause serious disability. By participating in the PT on Demand program, I hereby assume all risks and dangers and all responsibility for any losses and/or damages whether caused in whole or in part by the negligence or conduct of PT on Demand. I agree that I, my heirs, my assigns, or any other legal representative will release, waive, discharge, hold harmless, defend, and indemnify PT on Demand, its representatives, employees, and assigns from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services, or otherwise which may arise out of my use of any equipment or participation in the PT on Demand program. I specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct of PT on Demand.

I HAVE READ THE ABOVE CONSENT TO PARTICIPATION AND WAIVER AND RELEASE ANY BY SIGNING DOCUMENT, I AM AGREEING TO THIS CONSENT, WAIVER, AND RELEASE FROM LIABILITY. IT IS MY INTENTION TO EXEMPT AND RELIEVE PT ON DEMAND FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH BY ANY CAUSE.

Notice of Privacy Practices

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.

Effective Date: November 1, 2023

The Healthy Posture Club and PT on Demand may receive, create, transmit, or be required to disclose information about you that may qualify as Protected Health Information (“PHI”) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) or similar concepts under state laws. The Healthy Posture Club and its employees are dedicated to maintaining the privacy of your PHI, as required by applicable federal and state laws. These laws require us to provide you with this Notice of Privacy Practices, and to inform you of your rights and our obligations concerning PHI, which is information that identifies you and that relates to your physical or mental health condition. We will follow the privacy practices described below to the extent required by law while this Notice is in effect.

A. Permitted Disclosures of PHI. We may disclose your PHI for the following reasons:

1. Treatment. We may disclose your PHI to health care providers treating you. For example, we may disclose medical information about you to physical therapists, physicians, nurses, technicians, or personnel who are involved with the administration of your care.

2. Payment. We may disclose your PHI to bill you and to collect payment for the services we provide to you. For example, we may send a bill to you for the rendering of services by us. The bill may contain information that identifies you and services provided to you. We may also provide your PHI to billing companies, claims processing companies, and others that process our payments.

3. Health Care Operations. We may disclose your PHI in connection with our health care operations. Health care operations include quality assessment activities, reviewing the competence or qualifications of our employees, evaluating employee performance, and other business operations. We may also provide your PHI to accountants, attorneys, consultants, and others to make sure we comply with the laws that govern us.

4. Emergency Treatment. We may disclose your PHI if you require emergency treatment or are unable to communicate with us.

5. Family and Friends. We may disclose your PHI to a family member, friend, or any other person who you identify as being involved with your exercise and wellness services or payment for your exercise and wellness services, unless you object.

6. Required by Law. We may disclose your PHI for law enforcement purposes and as required by state or federal law. For example, the law may require us to report instances of abuse, neglect, or domestic violence; to report certain injuries such as gunshot

wounds; or to disclose PHI to assist law enforcement in locating a suspect, fugitive, material witness, or missing person. We will inform you or your representative if we disclose your PHI because we believe you are a victim of abuse, neglect, or domestic violence, unless we determine that informing you or your representative would place you at risk. In addition, we must provide PHI to comply with an order in a legal or administrative proceeding. Finally, we may be required to provide PHI in response to a subpoena discovery request or other lawful process, but only if efforts have been made, by us or the requesting party, to contact you about the request or to obtain an order to protect the requested PHI.

7. Serious Threat to Health or Safety. We may disclose your PHI if we believe it is necessary to avoid a serious threat to the health and safety of you or the public.

8. Public Health. We may disclose your PHI to public health or other authorities charged with preventing or controlling disease, injury, or disability, or charged with collecting public health data.

9. Health Oversight Activities. We may disclose your PHI to a health oversight agency for activities authorized by law. These activities include audits; civil, administrative, or criminal investigations or proceedings; inspections; licensure or disciplinary actions; or other activities necessary for oversight of the health care system, government programs and compliance with civil rights laws.

10. Research. We may disclose your PHI for certain research purposes, but only if we have protections and protocols in place to ensure the privacy of your PHI.

11. Workers’ Compensation. We may disclose your PHI to comply with laws relating to workers’ compensation or other similar programs.

12. Specialized Government Activities. If you are active military or a veteran, we may disclose your PHI as required by military command authorities. We may also be required to disclose PHI to authorized federal officials for the conduct of intelligence or other national security activities.

13. Organ Donation. If you are an organ donor, or have not indicated that you do not wish to be a donor, we may disclose your PHI to organ procurement organizations to facilitate organ, eye or tissue donation and transplantation.

14. Coroners, Medical Examiners, Funeral Directors. We may disclose your PHI to coroners or medical examiners for the purposes of identifying a deceased person or determining the cause of death, and to funeral directors as necessary to carry out their duties.

15. Disaster Relief. Unless you object, we may disclose your PHI to a governmental agency or private entity (such as FEMA or Red Cross) assisting with disaster relief efforts.

B. Disclosures Requiring Written Authorization.

1. Not Otherwise Permitted. In any other situation not described in Section A above, we may not disclose your PHI without your written authorization.

2. Marketing and Sale of PHI. We must receive your written authorization for any disclosure of PHI for marketing purposes or for any disclosure which is a sale of PHI.

C. Your Rights.

1. Right to Receive a Paper Copy of This Notice. You have the right to receive a paper copy of this Notice upon request.

2. Right to Access PHI. You have the right to inspect and copy your PHI for as long as we maintain your medical record. You must make a written request for access to the Privacy Officer at the address listed at the end of this Notice. We may charge you a reasonable fee for the processing of your request and the copying of your medical record pursuant to applicable state law. In certain circumstances we may deny your request to access your PHI, and you may request that we reconsider our denial. Depending on the reason for the denial, another licensed health care professional chosen by us may review your request and the denial.

3. Right to Request Restrictions. You have the right to request a restriction on the use or disclosure of your PHI for the purpose of treatment, payment, or exercise and wellness operations, except for in the case of an emergency. You also have the right to request a restriction on the information we disclose to a family member or friend who is involved with your exercise and wellness services or payment for your exercise and wellness services. However, we are not legally required to agree to such a restriction.

4. Right to Restrict Disclosure for Services Paid by You in Full. You have the right to restrict the disclosure of your PHI to a health plan if the PHI pertains to the exercise and wellness services for which you paid in full directly to us.

5. Right to Request Amendment. You have the right to request that we amend your PHI if you believe it is incorrect or incomplete, for as long as we maintain your medical record. We may deny your request to amend if (a) we did not create the PHI, (b) is not information that we maintain, (c) is not information that you are permitted to inspect or copy (such as psychotherapy notes), or (d) we determine that the PHI is accurate and complete.

6. Right to an Accounting of Disclosures. You have the right to request an accounting of disclosures of PHI made by us (other than those made for treatment, payment, or health care operations purposes) during the 6 years prior to the date of your request. You must make a written request for an accounting, specifying the time period for the accounting, to the Privacy Officer at the address listed at the end of this Notice.

7. Right to Confidential Communications. You have the right to request that we communicate with you about your PHI by certain means or at certain locations. For example, you may specify that we call you only at your home phone number, and not

at your work number. You must make a written request, specifying how and where we may contact you, to the Privacy Officer at the address listed at the end of this Notice.

8. Right to Notice of Breach. You have the right to be notified if we or one of our business associates become aware of a breach of your unsecured PHI.

D. Changes to this Notice. We reserve the right to change this Notice at any time in accordance with applicable law. Prior to a substantial change to this Notice related to the uses or disclosures of your PHI, your rights, or our duties, we will revise and distribute this Notice.

E. Acknowledgment of Receipt of Notice. We will ask you to sign an acknowledgment that you received this Notice.

F. Questions and Complaints. If you would like more information about our privacy practices or have questions or concerns, please contact us. If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made regarding the use, disclosure, or access to you PHI, you may complain to us by contacting the Privacy Officer at the address and phone number at the end of this Notice. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file such a complaint upon request.

We support your right to the privacy of your PHI. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services. Please direct any of your questions or complaints to:

Privacy Officer

PT on Demand

Healthy Posture Club

320 High Tide Drive

Suite 101A

St. Augustine, FL 3208

Cancellation Policy (Telehealth Services)

Cancellation Policy (VOD content)

In some cased you will be advised to purchase a Vimeo OTT subscription to access the workouts prescribed for home compliance. This is a purchase between you and Vimeo. All Vimeo subscriptions are set for auto-renewal and are billed on a monthly bases. It is your responsibility to cancel any active subscription for which you no longer want access. You can cancel your Vimeo subscription through your client portal by clicking on you initials in the top right corner of the site/app. Click the manage subscription option and make the appropriate changes. Subscriptions can be paused for any reason.