Terms & Conditions

1. Introduction and Acceptance

Welcome to Level Up PT Doc ("Practice," "we," "us," or "our"), a concierge physical therapy practice owned and operated by Dr. Grace Villaver, DPT. These Terms and Conditions ("Terms") govern your use of our website, services, and patient-provider relationship.

By accessing our website, scheduling an appointment, or receiving services from Level Up PT Doc, you acknowledge that you have read, understood, and agree to be bound by these Terms. If you do not agree to these Terms, please do not use our services.

These Terms constitute a legally binding agreement between you ("Patient," "Client," or "you") and Level Up PT Doc. We reserve the right to modify these Terms at any time, with changes effective upon posting to our website.

2. Description of Services

Level Up PT Doc provides premium, concierge-level physical therapy services delivered in the comfort of your home or preferred location. Our services include, but are not limited to:

• Comprehensive movement assessments and evaluations
• Functional movement therapy and mobility optimization
• Manual therapy techniques
• Therapeutic exercise prescription and instruction
• Pain management and resolution programs
• Post-surgical rehabilitation
• Injury prevention and performance optimization
• Lymphatic therapy and drainage
• Golf performance enhancement (TPI-based protocols)
• Balance and fall prevention programs

All services are provided by Dr. Grace Villaver, a licensed Doctor of Physical Therapy (DPT) in the Commonwealth of Virginia, with over 20 years of clinical experience.

Service Area

We provide in-home concierge services throughout Loudoun County and Northern Virginia, including but not limited to: Ashburn, Leesburg, Sterling, South Riding, Brambleton, Broadlands, Great Falls, Reston, Herndon, Chantilly, and surrounding areas.

3. Cash-Pay Practice Model

By choosing to receive services from Level Up PT Doc, you acknowledge and agree to the following:

Benefits of Our Cash-Pay Model

• Extended Session Times: Full 60-minute one-on-one sessions with Dr. Grace, not the industry-standard 15-20 minutes dictated by insurance reimbursement models
• No Insurance Restrictions: Treatment plans are determined solely by your clinical needs, not by insurance company limitations or pre-authorization requirements
• Direct Doctor Access: You work exclusively with Dr. Grace—never handed off to assistants, aides, or technicians
• Advanced Techniques: Access to specialized treatments that may not be covered by insurance
• Privacy: Your health information is not shared with insurance companies
• Convenience: Premium in-home service with flexible scheduling

Your Financial Responsibility

You are solely responsible for payment of all services rendered. Payment is due at the time of service unless other arrangements have been made in advance. By scheduling an appointment, you agree to pay the quoted fees regardless of any insurance coverage you may have.

4. Insurance and Third-Party Payers

No Insurance Billing

Level Up PT Doc does not participate in any insurance networks, Medicare, Medicaid, TRICARE, workers' compensation programs, or any other third-party payer programs. We do not submit claims to insurance companies on your behalf.

Superbill for Reimbursement

Upon request, we can provide you with a detailed receipt (superbill) containing the information typically required for you to submit a claim to your insurance company for potential out-of-network reimbursement. This superbill will include:

• Provider information and credentials
• Date(s) of service
• CPT procedure codes
• ICD-10 diagnosis codes
• Fees charged

Medicare Beneficiaries

If you are a Medicare beneficiary, please be aware that physical therapists cannot "opt out" of Medicare in the same manner as physicians. However, as a cash-pay practice, we do not bill Medicare for services. If you are a Medicare beneficiary and choose to receive services from our practice, you acknowledge that:

• You are choosing to pay privately for services
• We will not submit claims to Medicare on your behalf
• You may request a superbill but Medicare reimbursement is not guaranteed
• You have the right to seek services from Medicare-participating providers

5. Informed Consent for Physical Therapy

Physical therapy involves the evaluation and treatment of movement dysfunction, pain, and physical impairments. By receiving services from Level Up PT Doc, you consent to physical therapy evaluation and treatment as recommended by Dr. Grace Villaver, DPT.

Potential Benefits

Physical therapy treatment may result in:

• Reduction or elimination of pain
• Improved mobility, flexibility, and range of motion
• Increased strength, endurance, and functional capacity
• Enhanced balance and coordination
• Improved ability to perform daily activities
• Prevention of future injuries
• Accelerated recovery from surgery or injury

Potential Risks

As with any healthcare treatment, physical therapy carries certain risks, including but not limited to:

• Temporary increase in pain or discomfort during or after treatment
• Muscle soreness following therapeutic exercise
• Fatigue
• Bruising or skin irritation from manual therapy techniques
• Aggravation of existing conditions (rare)
• In rare cases, injury to muscles, ligaments, or other tissues

If you experience any unusual or prolonged discomfort following treatment, please contact us immediately. Most post-treatment soreness resolves within 24-48 hours.

Alternative Treatments

Alternatives to physical therapy may include, but are not limited to: medication, injections, chiropractic care, acupuncture, massage therapy, surgical intervention, or no treatment. You have the right to discuss these alternatives with your healthcare providers.

Right to Refuse or Withdraw

You have the right to refuse any treatment or procedure at any time. You may also withdraw your consent and discontinue treatment at any time without penalty.

6. Virginia Direct Access Provisions

Under Virginia law (§ 54.1-3482.1 of the Code of Virginia), patients may receive physical therapy services without a physician referral under certain conditions. Dr. Grace Villaver holds a Doctor of Physical Therapy (DPT) degree and is certified to provide direct access services in Virginia.

Direct Access Requirements

When receiving services under Virginia's direct access provisions, you acknowledge and consent to the following:

• Healthcare Provider Identification: You will identify a licensed healthcare provider (physician, nurse practitioner, or physician assistant) to whom we may send evaluation reports and communicate regarding your care
• Written Consent: You consent to the release of your physical therapy records and protected health information to the identified healthcare provider
• Initial Evaluation Report: We will provide a copy of your initial evaluation and patient history to your identified healthcare provider within 14 days of commencing treatment
• Treatment Duration: Under direct access, we may evaluate and treat you for up to 30 consecutive days. After 30 days, continued treatment requires a referral from a licensed healthcare provider
• Referral for Medical Conditions: If Dr. Grace determines that your condition is beyond the scope of physical therapy practice, you will be immediately referred to an appropriate healthcare provider

Direct Access Patient Attestation

By receiving direct access services, you attest that:

• The information you provide regarding your health history is accurate and complete
• You will inform us of any changes in your medical condition
• You understand the limitations of physical therapy practice and the importance of medical evaluation when appropriate

7. Scheduling and Cancellation Policy

Appointment Scheduling

Appointments may be scheduled by phone, email, or through our website contact form. We offer flexible scheduling, including early morning, evening, and weekend appointments when available.

Cancellation Policy

We understand that circumstances may arise requiring you to cancel or reschedule an appointment. However, as a concierge practice with limited availability, cancellations significantly impact our ability to serve other patients. Therefore, we require:

No-Show Policy

Failure to be present for a scheduled appointment without prior notice ("no-show") will result in a charge equal to 100% of the scheduled session fee. Repeated no-shows may result in termination of the patient-provider relationship.

Late Arrivals

If you are not available at the scheduled time for your in-home appointment, we will wait up to 15 minutes. After 15 minutes, the appointment may be considered a no-show. If you know you will be late, please contact us as soon as possible so we can attempt to accommodate the delay.

Provider Cancellations

In the rare event that we must cancel an appointment, we will provide as much notice as possible and work with you to reschedule at a mutually convenient time. You will not be charged for appointments cancelled by the provider.

8. Payment Terms

Fees

Current fees for services will be provided to you prior to your initial appointment and are also available upon request. Fees are subject to change with reasonable notice.

Payment Methods

We accept the following forms of payment:

• Cash
• Personal check
• Credit cards (Visa, Mastercard, American Express, Discover)
• Health Savings Account (HSA) cards
• Flexible Spending Account (FSA) cards

Payment Due Date

Payment is due at the time of service unless alternative arrangements have been made in advance. For package purchases, full payment is due at the time of purchase.

Returned Checks

A fee of $35 will be charged for any returned checks.

Collections

Accounts that remain unpaid for more than 60 days may be referred to a collection agency. You will be responsible for any collection costs and fees incurred.

Good Faith Estimate

Under the No Surprises Act, you have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost. You can ask any healthcare provider for a Good Faith Estimate before you schedule an item or service. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

9. Patient Responsibilities

To achieve optimal outcomes from your physical therapy program, you agree to:

Provide Accurate Information

• Provide complete and accurate information about your health history, current symptoms, medications, and any other relevant medical information
• Inform us of any changes in your health status or medications
• Notify us immediately if you experience unusual symptoms or adverse reactions to treatment

Active Participation

• Actively participate in your treatment sessions
• Perform prescribed home exercises as instructed
• Follow recommendations regarding activity modifications, precautions, and lifestyle changes
• Communicate openly about your progress, concerns, and goals

Safe Treatment Environment

For in-home sessions, you agree to:

• Provide a safe, clean, and appropriate space for treatment
• Secure pets during treatment sessions
• Ensure appropriate lighting and temperature
• Have any requested equipment or props available as discussed

Respectful Conduct

We expect all patients to treat Dr. Grace and any staff with respect and courtesy. Abusive, threatening, or inappropriate behavior will not be tolerated and may result in immediate termination of services.

10. Privacy and HIPAA Compliance

Level Up PT Doc is committed to protecting your privacy and complying with the Health Insurance Portability and Accountability Act (HIPAA) and all applicable state privacy laws.

Notice of Privacy Practices

A complete Notice of Privacy Practices (NPP) is available upon request and will be provided to you at or before your first appointment. The NPP describes:

• How we may use and disclose your protected health information (PHI)
• Your rights regarding your PHI
• Our legal duties regarding your PHI
• How to file a complaint if you believe your privacy rights have been violated

Use and Disclosure of PHI

We may use and disclose your PHI for:

• Treatment: To provide, coordinate, and manage your healthcare
• Payment: To prepare superbills and other documentation you may need for reimbursement
• Healthcare Operations: For quality assessment, training, and practice management
• As Required by Law: When required by federal, state, or local law
• With Your Authorization: For any other purposes with your written authorization

Your Rights

Under HIPAA, you have the right to:

• Access and obtain copies of your PHI
• Request amendments to your PHI
• Receive an accounting of disclosures of your PHI
• Request restrictions on certain uses and disclosures
• Request confidential communications
• File a complaint if you believe your privacy rights have been violated

Security Measures

We implement appropriate administrative, physical, and technical safeguards to protect your PHI from unauthorized access, use, or disclosure, including:

• Secure electronic health record systems
• Encrypted communications
• Secure storage of paper records
• Staff training on privacy and security practices

11. Telehealth Services

Level Up PT Doc may offer telehealth services for certain consultations, follow-up appointments, and home exercise program instruction when clinically appropriate.

Telehealth Consent

By participating in telehealth services, you acknowledge and consent to the following:

• Telehealth involves the use of electronic communications to enable healthcare providers to deliver services remotely
• Telehealth may not be as complete as an in-person evaluation
• There are potential risks including, but not limited to, technology failures, interruptions, and security breaches
• You have the right to refuse telehealth services at any time

Technical Requirements

For telehealth sessions, you are responsible for:

• Having access to a device with video and audio capabilities
• Ensuring a stable internet connection
• Being in a private, safe, and appropriate environment for the session
• Having adequate space to perform any prescribed exercises

HIPAA-Compliant Platform

All telehealth services are conducted using HIPAA-compliant video conferencing platforms that provide appropriate security and encryption for your protected health information.

12. Medical Records

Record Retention

We maintain your medical records in accordance with Virginia law and professional standards. Adult patient records are retained for a minimum of six (6) years from the date of last treatment. Records of minor patients are retained until the patient reaches the age of 18, plus an additional period as required by law.

Requesting Your Records

You have the right to request copies of your medical records. To request records:

• Submit a written request specifying the records you need
• Include any necessary authorization for release to third parties
• Allow up to 30 days for processing

A reasonable fee may be charged for copying and mailing records, in accordance with Virginia law.

Record Transfer

Upon written request, we will transfer your records to another healthcare provider. Please provide the receiving provider's name, address, and fax number or secure email address.

13. Electronic Communications

Email and Text Communication

You may choose to communicate with us via email or text message for scheduling, appointment reminders, and general inquiries. By providing your email address or phone number, you consent to receive such communications.

Response Times

We strive to respond to all communications within 24-48 business hours. For urgent matters, please call us directly. Email and text messages are not appropriate for emergencies.

Emergency Communications

If you are experiencing a medical emergency, call 911 immediately. Our practice does not provide emergency services, and electronic communications are not monitored outside of business hours.

14. Termination of Services

Patient-Initiated Termination

You may terminate your care with Level Up PT Doc at any time for any reason. We request that you notify us of your decision so that we may provide appropriate discharge documentation and referrals if needed.

Provider-Initiated Termination

Level Up PT Doc reserves the right to terminate the patient-provider relationship for reasons including, but not limited to:

• Non-payment of fees
• Repeated missed appointments or late cancellations
• Non-compliance with treatment recommendations that compromises your safety or the effectiveness of care
• Abusive, threatening, or inappropriate behavior toward Dr. Grace or staff
• Providing false or misleading information
• Circumstances that make it impossible to provide safe and effective care

Except in cases of immediate safety concerns or egregious conduct, we will provide reasonable notice (typically 30 days) and assist with referrals to other providers.

Discharge

Upon completion of your treatment goals or termination of services, we will provide a discharge summary and any necessary referrals. Your records will be maintained in accordance with our retention policy.

15. Limitation of Liability

Professional Services

Dr. Grace Villaver, DPT, provides physical therapy services in accordance with the standard of care for physical therapy practice in Virginia. Nothing in these Terms shall be construed to limit liability for professional negligence or malpractice.

Assumption of Risk

Physical therapy, like all healthcare interventions, carries inherent risks. By receiving services, you acknowledge that you understand and accept the potential risks described in the Informed Consent section of these Terms.

Third-Party Services

Level Up PT Doc is not responsible for the actions, services, or recommendations of other healthcare providers to whom you may be referred or who may be involved in your care.

Website and Information

Information provided on our website, social media, or other communications is for general educational purposes only and should not be considered medical advice. Always consult with a qualified healthcare provider for specific medical questions or concerns.

16. Website Terms of Use

No Doctor-Patient Relationship

Use of our website does not establish a doctor-patient relationship. A patient-provider relationship is established only when you have been formally accepted as a patient and have received services from Level Up PT Doc.

Information Disclaimer

The content on our website is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

No Warranties

Our website is provided "as is" without any representations or warranties, express or implied. We make no representations or warranties regarding the accuracy, completeness, or reliability of any content on the website.

Links to Third-Party Websites

Our website may contain links to third-party websites. These links are provided for your convenience only. We have no control over and assume no responsibility for the content, privacy policies, or practices of any third-party websites.

Testimonials and Results

Any testimonials or success stories displayed on our website represent individual experiences and results. Results may vary, and testimonials do not guarantee that you will achieve similar outcomes.

17. Intellectual Property

All content on the Level Up PT Doc website, including but not limited to text, graphics, logos, images, videos, and software, is the property of Level Up PT Doc or its content suppliers and is protected by United States and international copyright laws.

You may not reproduce, distribute, modify, create derivative works of, publicly display, publicly perform, republish, download, store, or transmit any of the material on our website without prior written consent, except for:

• Temporary storage in your computer's RAM incidental to accessing and viewing the content
• Storing files automatically cached by your web browser for display enhancement
• Printing or downloading one copy of a reasonable number of pages for your personal, non-commercial use

18. Dispute Resolution

Governing Law

These Terms shall be governed by and construed in accordance with the laws of the Commonwealth of Virginia, without regard to its conflict of law provisions.

Informal Resolution

We encourage you to contact us directly to resolve any concerns or disputes informally. Most issues can be resolved through open communication.

Complaints

If you have concerns about the quality of care you received, please contact us directly. You also have the right to file a complaint with:

• Virginia Board of Physical Therapy: www.dhp.virginia.gov/Boards/PhysicalTherapy
• For HIPAA complaints: U.S. Department of Health and Human Services Office for Civil Rights

Venue

Any legal action or proceeding arising out of or relating to these Terms shall be brought exclusively in the state or federal courts located in Loudoun County, Virginia, and you consent to the jurisdiction of such courts.

19. Modifications to Terms

Level Up PT Doc reserves the right to modify these Terms at any time. Changes will be effective immediately upon posting to our website. The "Last Updated" date at the top of these Terms will be revised accordingly.

Your continued use of our services after any modifications constitutes your acceptance of the revised Terms. We encourage you to review these Terms periodically.

For significant changes that materially affect your rights or obligations, we will make reasonable efforts to notify you via email or other direct communication.

20. Contact Information

For questions about these Terms, privacy practices, or to request copies of any forms or policies referenced herein, please contact us using the information above.

Acknowledgment

By scheduling an appointment, receiving services, or using the Level Up PT Doc website, you acknowledge that you have read, understood, and agree to be bound by these Terms and Conditions. If you have any questions about these Terms, please contact us before proceeding.

Thank you for choosing Level Up PT Doc for your physical therapy needs. We are committed to providing you with exceptional, personalized care.