Effective Date: 02/16/2026 (updated to reflect current law)

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Responsibilities
We are required by law to:
Maintain the privacy and security of your protected health information (PHI); Provide you with this Notice of our legal duties and privacy practices;
Follow the terms of this Notice while it is in effect; and Notify you following a breach of unsecured PHI.
We reserve the right to change our privacy practices and this Notice as permitted by law. Any material changes will apply to all PHI we maintain and will be posted at our practice location and available upon request.

How We May Use and Disclose Your Health Information
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your dental care.
Example: Sharing information with a specialist involved in your treatment.

Payment
We may use and disclose your PHI to bill and collect payment for services.
Example: Submitting claims to your dental insurance plan.

Health Care Operations
We may use and disclose PHI for business operations such as quality improvement, training, credentialing, audits, and licensing.

Individuals Involved in Your Care
We may disclose PHI to family members, friends, or others you identify who are involved in your care or payment, unless you object. Personal representatives are treated the same as you under the law.

Public Health and Safety
We may disclose PHI as required or permitted by law, including for:
• Public health reporting;
• Abuse, neglect, or domestic violence reporting;
• Product recalls or adverse events;
• Disaster relief efforts.

Legal, Regulatory, and Oversight Uses
We may disclose PHI when required by law, including for:
• Law enforcement purposes;
• Judicial or administrative proceedings;
• Health oversight activities;
• Workers’ compensation;
• National security and military activities;
• The U.S. Department of Health and Human Services for HIPAA compliance.

Research
We may disclose PHI for approved research purposes when required privacy safeguards are in place.

Coroners and Funeral Directors
PHI may be disclosed to identify a deceased person or determine cause of death, or as necessary for funeral arrangements.

Fundraising
We may contact you regarding fundraising activities. You may opt out at any time.

Special Privacy Protections
Certain information is subject to heightened protections, including:
Substance Use Disorder (SUD) Records