Notice of Privacy Practices

Our Legal Duty

We are required by law to protect the privacy and security of your protected health information (PHI), give you this notice of our legal duties and privacy practices, and follow the notice currently in effect. PHI is information that identifies you, or could reasonably identify you, and relates to your health, the care you receive, or payment for that care. It can include dental records, X-rays, treatment notes and billing information, whether held electronically, on paper or communicated verbally.

We will not use or share your information in ways other than those described in this notice unless you authorize us in writing or the law permits or requires it. Where applicable law provides stronger privacy protections than HIPAA, we follow those protections.

Website Communications Disclaimer

Website forms and ordinary email are not secure channels and are not intended for PHI. Do not send health details, dental records, X-rays or other sensitive information through website forms or ordinary email. Use the patient portal or call our office to arrange an appropriate way to share sensitive information.

How We May Use and Disclose Your Health Information

The following describes uses and disclosures that may be made without your written authorization, subject to applicable legal limits. When required, we limit the information shared to the minimum necessary for the purpose.

Information disclosed to a recipient may be shared again by that recipient and may no longer be protected by HIPAA, although other laws may still protect it. If we receive substance use disorder records protected by 42 CFR Part 2, additional protections apply. Records received with consent for treatment, payment and healthcare operations may be used and shared as HIPAA permits, but cannot be used or disclosed in civil, criminal, administrative or legislative proceedings against you without your specific written consent or a court order meeting Part 2 requirements and any other required legal process.

Treatment

We may use and share your health information to provide, coordinate or manage your dental care. For example, we may discuss your treatment with a specialist, share relevant records with another treating provider, or give a dental laboratory information needed for your care.

Payment

We may use and disclose information to bill for services, obtain payment or help determine insurance coverage. For example, a health plan may need information about a procedure before paying a claim. Your right to restrict certain disclosures to a health plan when you pay in full out of pocket is described below.

Healthcare Operations

We may use and share information to run the practice, evaluate and improve care, train staff, conduct audits, and meet administrative and compliance responsibilities. Service providers who handle PHI for us must protect it as required by law and any applicable business associate agreement.

Appointment Reminders

We may contact you by phone, text message, email or mail about appointments and related care. Text messages and ordinary email may not be secure. You may ask us to contact you in a different way or at a different location, as described under confidential communications below.

As Required by Law

We disclose information when federal, state or local law requires it, and only to the extent required by that law.

Public Health Activities

We may disclose information to authorized public health authorities for purposes such as preventing or controlling disease, reporting certain injuries or suspected abuse or neglect, and reporting problems with medicines or medical products, when permitted or required by law.

Health Oversight Activities

We may share information with agencies legally authorized to oversee the healthcare system, including for audits, investigations, inspections, licensing and other authorized oversight activities.

Serious Threats to Health or Safety

Consistent with applicable law and professional standards, we may disclose information when we believe in good faith that it is necessary to prevent or lessen a serious and imminent threat to a person or the public. We may share it with someone reasonably able to help prevent or lessen the threat.

Workers' Compensation

We may disclose information as authorized by and necessary to comply with workers' compensation laws or similar programs that provide benefits for work-related illness or injury.

Legal Proceedings

We may disclose information in response to a court or administrative order. For a subpoena, discovery request or other lawful process without an order, we disclose only when the privacy safeguards and other conditions required by applicable law have been met.

Law Enforcement

We may disclose information to law enforcement officials in limited circumstances allowed or required by law, such as certain legal orders, required reports, or requests involving identification, victims or crimes. A request alone does not permit unrestricted access to your records.

Coroners, Medical Examiners and Funeral Directors

We may share information with a coroner or medical examiner to identify a deceased person, determine a cause of death or perform other legally authorized duties. We may share information with funeral directors as needed for their lawful duties.

Organ and Tissue Donation

We may disclose information to organizations involved in organ, eye or tissue procurement, banking or transplantation to support donation and transplantation as permitted by law.

Military and Veterans

If you are a member of the armed forces, we may disclose information to appropriate military authorities under the conditions required by law. Disclosures involving veterans' benefits or foreign military personnel are made only as permitted by applicable law.

National Security and Intelligence

We may disclose information to authorized federal officials for lawful intelligence, counterintelligence and other national security activities as permitted by law.

Uses and Disclosures That Require Your Written Authorization

Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing, and disclosures that constitute a sale of PHI require your written authorization, except for limited exceptions allowed by law. Other uses or disclosures not described in this notice also require your authorization unless otherwise permitted or required by law.

You may revoke an authorization at any time by notifying our Privacy Officer in writing. Revocation applies going forward; it cannot undo actions we have already taken in reliance on your authorization.

Your Rights Regarding Your Health Information

Contact our Privacy Officer using the details below to exercise these rights. We will explain any request process and applicable legal requirements.

Right to Inspect and Copy

You may ask to inspect or receive a paper or electronic copy of health and billing information in the records we maintain about you. We generally respond within 30 days; if a permitted extension is needed, we will explain the reason and timing in writing. We may charge a reasonable, cost-based fee where allowed by law. Some information is subject to legal exceptions. If we deny access, we will explain the reason and any right to have the denial reviewed.

Right to Request an Amendment

You may ask us in writing to correct information you believe is inaccurate or incomplete, explaining why a change is needed. We generally respond within 60 days, subject to a permitted extension. We may deny a request for reasons allowed by law, such as when the record is accurate and complete or was not created by us and the original creator remains available. We will explain a denial in writing and how you may submit a statement of disagreement.

Right to an Accounting of Disclosures

You may request a list of certain disclosures made during the six years before your request. The accounting generally does not include disclosures for treatment, payment or healthcare operations, disclosures you authorized, or other disclosures excluded by law. The first accounting in any 12-month period is free. We may charge a reasonable, cost-based fee for additional requests after telling you the cost and allowing you to withdraw or modify the request.

Right to Request Restrictions

You may ask us not to use or disclose certain information for treatment, payment or healthcare operations, or to limit information shared with people involved in your care. We are generally not required to agree, but we will follow restrictions we accept except as permitted by law, including when information is needed for emergency treatment.

We must honor your request not to disclose information to your health plan for payment or healthcare operations when the information relates solely to a healthcare item or service that you, or someone other than the health plan on your behalf, paid for in full out of pocket, unless the disclosure is required by law. Please tell us before we submit a claim so we can arrange this restriction.

Right to Request Confidential Communications

You may ask us to contact you in a particular way or at a particular location, such as calling a different number or sending mail to another address. We will accommodate reasonable requests and will not require you to explain why you are making the request. We may ask how payment will be handled and for an alternative contact method or address.

Right to a Paper Copy of This Notice

You may request a paper copy at any time, even if you agreed to receive this notice electronically. The current notice is posted in our office and on our website.

Right to Be Notified of a Breach

You have the right to be notified if a breach of your unsecured PHI occurs that requires notification under the law. We will notify you without unreasonable delay and no later than 60 days after discovery, unless a delay is permitted by law.

Changes to This Notice

We may change this notice and our privacy practices as permitted by law. Changes may apply to information we already hold as well as information we receive later. The updated notice will show its effective date and will be available on request, posted in the office and posted on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services Office for Civil Rights. Visit www.hhs.gov/ocr or call 1-800-368-1019 for information about filing a complaint. We will not retaliate against you for filing a complaint.

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This notice is effective as of November 2026 and supersedes all previous versions.