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Policy and Procedures

KINEMATICS WITH KELLY, LLC

CLIENT POLICY & MASTER AGREEMENT

The Recovery Room:

Policies, Procedures, Informed Consent, Terms & Liability Release

The Recovery Room Hub | The Recovery Room on Wheels

1104 Bolin Ct, Springfield, IL 62703

📧 levelup@kinematicswithkelly.com | www.kinematicswithkelly.com

☎ (217) 331-4700

Kinematics with Kelly, LLC

Kinematics with Kelly, LLC (“KWK”)

Brands: The Recovery Room | The Recovery Room on Wheels

Primary Location: 1104 Bolin Ct, Springfield, IL 62703📧 levelup@kinematicswithkelly.com | ☎ (217) 331-4700

Owner & Treating Clinician: Dr. Kelly Neumann, DPT, CIDN

Illinois Physical Therapy License: #070018951NPI: 1942573415

EIN: 99-2269313

Professional and Business Liability Insurance: HPSO (Active Coverage)

Effective Date: January 2025


1. BUSINESS IDENTITY & PROFESSIONAL AUTHORITY

Kinematics with Kelly, LLC (“KWK”) is a Doctor of Physical Therapy–led performance, recovery, and wellness practice, founded and operated by Dr. Kelly Neumann, DPT, CIDN, a Board-Licensed Doctor of Physical Therapy in the State of Illinois, regulated by the Illinois Department of Financial & Professional Regulation (IDFPR) under the Illinois Physical Therapy Practice Act (225 ILCS 90).

KWK operates through two service divisions:

  • The Recovery Room (Fixed Location): Springfield, Illinois

  • The Recovery Room on Wheels (Mobile Services): On-site services for teams, schools, events, churches, organizations, and community partners

All services are rendered under the education, clinical judgment, and ethical authority of a licensed Doctor of Physical Therapy, but are not delivered as traditional insurance-based Plans of Care (POC).

2. REGULATORY DISTINCTION OF SERVICES (THE DIAGNOSTIC WALL)

KWK provides proactive, movement-based, recovery and wellness services that are cash-based and education-focused.

KWK DOES

  • Identify movement impairments, biomechanical inefficiencies, and functional limitations

  • Use objective movement and force data to inform clinical decision-making

  • Provide recovery, wellness, and performance-supportive interventions

KWK DOES NOT

  • Diagnose medical disease or pathology

  • Prescribe medication

  • Interpret diagnostic imaging

  • Replace physician-directed medical care

Important Notice:Participation in KWK services does not establish a medical diagnosis, physician-directed Plan of Care, or insurance-driven patient relationship.If medical pathology is suspected, KWK will stop services and initiate referral.

3. DATA-INFORMED MOVEMENT ANALYSIS (HUMANTRAK & FORCEDECKS)

KWK utilizes HumanTrak markerless motion capture and VALD ForceDecks force plate systems to collect objective, quantifiable movement data.

Purpose of Data Use:

  • Establish movement baselines

  • Identify asymmetries (commonly ≥15% thresholds)

  • Educate clients on movement efficiency and load tolerance

  • Inform recovery and performance planning

Data Disclaimer:Movement data is educational and functional in nature. It does not diagnose medical conditions, predict injury, or guarantee outcomes.

Data Storage & Privacy:

  • Stored in HIPAA-aligned, encrypted platforms (VALD Move Health)

  • Accessible only to KWK and the Client

  • Never sold or externally distributed

  • Available to the Client upon request

4. SERVICES PROVIDED

Services may include, but are not limited to:

  • Movement analysis and recovery sessions

  • Manual therapy and soft-tissue techniques

  • Therapeutic movement and load education

  • Recovery and wellness services

  • Integrative Dry Needling

  • Cupping therapy

  • HumanTrak & ForceDecks testing

  • Educational workshops (#Mission2Move, Youth Athlete 101, Active Aging)

  • Mobile performance and recovery services

All services are proactive, movement-based, and wellness-oriented.

5. INFORMED CONSENT & ASSUMPTION OF RISK

By booking or participating in services, the Client:

  • Consents to hands-on care, movement analysis, and recovery interventions

  • Understands that individual response varies and no outcome is guaranteed

  • Voluntarily assumes all risks associated with physical activity, recovery services, and participation

6. INTEGRATIVE DRY NEEDLING — SPECIALIZED CONSENT

Integrative Dry Needling is a movement-informed neuromuscular technique performed by a licensed Doctor of Physical Therapy.It is not acupuncture and involves no medication injection.

Potential Risks:

  • Soreness or bruising

  • Bleeding or hematoma

  • Fatigue

  • Rare but serious risks including pneumothorax, nerve irritation, or infection

MANDATORY DISCLOSURE (REQUIRED PRIOR TO NEEDLING):Clients must disclose to Dr. Kelly Neumann:

  • Pregnancy (current or suspected)

  • Anticoagulant or blood-thinner use

  • Bleeding disorders

  • Immune compromise or active infection

  • Cardiac pacemakers or implants

  • Needle phobia or history of fainting

KWK reserves the right to decline or discontinue Integrative Dry Needling for safety.All Dry Needling services are private-pay only.

7. CLIENT RESPONSIBILITIES & SAFETY / STOP-AND-REFER PROTOCOL

Clients agree to:

  • Provide complete and accurate health history

  • Follow safety instructions

  • Communicate symptoms honestly

Services stop immediately if the Client experiences:

  • Chest pain or shortness of breath

  • Severe dizziness or neurological symptoms

  • Fever, infection, suspected fracture, or signs of DVT

If symptoms fail to improve within 30 days, referral is required per Illinois law.

8. MOBILE SERVICES — THE RECOVERY ROOM ON WHEELS

Mobile services involve inherent environmental risks, including terrain, weather, equipment, and third-party facilities.

  • KWK is not liable for injuries resulting from host-site conditions

  • Host organizations are responsible for providing a safe environment

Out-of-State Services:Services provided outside Illinois are performance education and recovery support only and do not constitute licensed physical therapy in other jurisdictions.

9. AFFILIATES, PARTNERS & THIRD-PARTY PARTICIPATION

Affiliate Definition

“Affiliates” include, but are not limited to:

  • Independent contractors

  • Consultants and specialists

  • Coaches or trainers

  • Event partners and host organizations

  • Volunteers, interns, or students

  • Technology, data-collection, or educational partners

  • Any individual or entity acting in coordination with KWK

Affiliate Participation & Risk Acknowledgment

The Client acknowledges that services may involve interaction with Affiliates in clinical, mobile, group, or event-based settings and voluntarily assumes all risks associated with such participation.

Extended Waiver & Release

To the fullest extent permitted by Illinois law, the Client waives, releases, and discharges:

  • Kinematics with Kelly, LLC

  • Dr. Kelly Neumann, DPT, CIDN

  • KWK employees, agents, and representatives

  • All Affiliates (known or unknown)

from any claims arising from participation, including claims based on ordinary negligence.

Affiliate Indemnification

The Client agrees to indemnify and hold harmless KWK and all Affiliates from claims arising from:

  • Failure to disclose medical history or contraindications

  • Participation beyond personal capacity

  • Voluntary disclosure of sensitive information

  • Failure to follow safety instructions

Affiliates may operate as independent entities and are not employees of KWK unless explicitly stated in writing.

10. FINANCIAL POLICY & CANCELLATIONS

KWK is a cash-based practice.

  • Insurance is not billed or verified

  • Superbills are not provided

  • Payment is due at booking or time of service

Cancellation Policy:

  • Standard Services: 24-hour notice required

  • Mobile / Team Services: 72-hour notice required

Late cancellations or no-shows are billed at 100% of the service fee.Services rendered are non-refundable.

11. MEDIA, DATA & DIGITAL COMMUNICATION

Clients authorize KWK to use de-identified photos, videos, and performance data for education and marketing unless revoked in writing.

AI & PHI DISCLAIMER

KWK utilizes AI tools (ManyChat, Dr. Mission2Move) for education and scheduling only.These platforms are not HIPAA-covered systems.

Clients must not submit Protected Health Information (PHI) through AI chats.If PHI is voluntarily submitted, the Client assumes all associated risk.

12. WAIVER, LIMITATION OF LIABILITY & INDEMNIFICATION

This is a binding legal agreement.

  • Clients assume all risks of participation

  • KWK and all Affiliates are released from liability for ordinary negligence

  • Liability is limited to fees paid in the three (3) months preceding any claim

  • Clients agree to indemnify KWK and Affiliates for claims arising from nondisclosure or unsafe participation

13. GOVERNING LAW & DISPUTE RESOLUTION

This Agreement is governed by the laws of the State of Illinois.

Disputes shall be resolved by:

  1. Good-faith negotiation

  2. Mediation in Springfield, Illinois

  3. Litigation exclusively in Sangamon County, Illinois

14. ENTIRE AGREEMENT & ACKNOWLEDGMENT

This document constitutes the entire agreement between the Client and KWK.

By booking services, signing electronically, or participating, the Client confirms they have read, understood, and agreed to all terms.

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