This notice describes how your health
information may be used and shared, and how you can access it. Please read it carefully.
You have the right to:
• Request a copy of your dental records
• Ask us to correct inaccurate or incomplete information
• Request confidential communication (e.g., by phone or mail)
• Ask us to limit what we use or share
• Get a list of who we’ve shared your information with (upon request)
• Receive a paper or digital copy of this notice at any time
• File a complaint without fear of retaliation
We may use or share your information to:
• Provide dental treatment and coordinate care
• Bill and collect payment from you or your insurance
• Run our practice operations (e.g., quality improvement, staff training)
• Comply with legal or public health requirements
• Respond to law enforcement or court orders when required
We will never sell your information or use it for marketing without your written permission.
• We are required by law to protect your health information.
• We will notify you promptly if a breach occurs that may compromise your data.
• We follow the privacy practices described in this notice and will update it as needed.
We will never sell your information or use it for marketing without your written permission.