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.

We respect our obligation to keep your health information private. We are obligated by law to give you notice of our privacy practices. This notice describes how we protect your health information and what rights you have regarding it.

USES AND DISCLOSURE OF HEALTH INFORMATION

We may use and disclose your health information to a denturist, dentist or other healthcare provider for treatment purposes. We may use and disclose your health information to bill and collect payment for services we provide to you. Within our professionaljudgment and unless you object, we will share relevant health and dental information with family and friends assisting in your care. We will not use your information for marketing without your written authorization. We will disclose your health information when required by federal, state or local law authorities or legal processes such as, but not limited to subpoena, court order, warrants or summons. We may disclose your information to appropriate authorities if we reasonably suspect you are a victim of a possible crime so as to avert serious threat to your safety and the safety of those around you. We may use your information to provide appointment reminders such as, but not limited to post cards, voicemail or letters.

PATIENT RlGHTS

You have the right to look at or get copies of your health information with limited exceptions. This request may be sent in writing to one of the addresses listed above via certified mail. you will be charged a reasonable fee for copies, postage and staff time. You may have the right to place additional restrictions on usage or disclosure of your health information. We are not required by law to agree to these restrictions. To the best of our ability, we will abide by restrictions except in the event of an emergency in our professional opinion. you may request alternate means or locations of which to discuss your information. This must be presented in writing with a satisfactory explanation and detailed format of how payments will be handled under the alternate means or location you request. You have the right to amend your health information in writing and it must explain why the amendment is to take place. We may deny your request under certain circumstances.

By law, we must abide by the terms of the Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time as allowed by law. lf we change this notice, the new privacy practices will apply to your health information that we already have, as well as to such information that we may generate in the future. lf we change our Notice of Privacy Practices, we will post the new notice and have copies available in our office.

COMPLAINTS

lf you think we have not properly respected the privacy of your health information, you are free to complain to us or the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you if you make a complaint. lf you want to complain to us, send a written complaint to the office contact person at one of the addresses listed at the top of this notice.