Notice of Privacy Practices

Effective Date & Our Duties

We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices, and to notify affected individuals following a breach of unsecured protected health information. We must follow the privacy practices described in this Notice while it is in effect. This Notice takes effect February 16, 2026, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this Notice at any time, as permitted by applicable law. When we make a significant change, we will post the new Notice at our practice location and provide copies upon request. You may request a copy of our Notice at any time by contacting us using the information at the end of this Notice.

How We May Use and Disclose Health Information About You

We may use and disclose your health information for different purposes. Some information, such as HIV-related information, genetic information, alcohol and/or substance abuse records, and mental health records may be entitled to special confidentiality protections under applicable state or federal law. We will abide by these special protections as they pertain to applicable cases.

Treatment

We may use and disclose your health information for your treatment. For example, we may disclose your health information to a specialist providing treatment to you.

Payment

We may use and disclose your health information to obtain reimbursement for treatment and services, including billing, collections, claims management, and determinations of eligibility and coverage. For example, we may send claims to your dental health plan containing certain health information.

Healthcare Operations

We may use and disclose your health information in connection with our healthcare operations, including quality assessment, training programs, and licensing activities.

Individuals Involved in Your Care

We may disclose your health information to your family, friends, or any other individual you identify who is involved in your care or the payment for your care. If a person has the legal authority to make healthcare decisions for you, we will treat that representative the same as we would treat you.

Required by Law & Public Health Activities

We may use or disclose your health information when required to do so by law, or for public health activities, including disclosures to:

• Prevent or control disease, injury, or disability
• Report child abuse or neglect
• Report reactions to medications or problems with products or devices
• Notify a person who may have been exposed to a disease or condition
• Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence

National Security, Law Enforcement & Other Disclosures

We may disclose health information to military authorities, authorized federal officials for national security activities, correctional institutions, law enforcement officials as permitted by HIPAA, health oversight agencies, the Secretary of HHS when required for HIPAA compliance, and as required under workers' compensation laws.

Your Rights Regarding Health Information About You

Right to Inspect and Copy

You have the right to inspect and obtain a copy of health information that may be used to make decisions about your care, including medical and billing records. To inspect or copy your health information, submit your request in writing to our office. We may charge a reasonable fee for the cost of copying, mailing, or other supplies associated with your request.

Right to Request Amendment

If you believe health information we have about you is incorrect or incomplete, you may request an amendment. You must provide your request and the reason for it in writing. We may deny your request in certain circumstances.

Right to an Accounting of Disclosures

You have the right to request a list of disclosures of your health information made for purposes other than treatment, payment, healthcare operations, and certain other activities.

Right to Request Restrictions

You have the right to request a restriction or limitation on the health information we use or disclose about you. We are not required to agree to your request, except in the case of a restriction on disclosure to a health plan for a service you paid for in full out of pocket.

Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. We will accommodate all reasonable requests.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically. Contact our office to obtain a copy.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.

To file a complaint with our office, please contact us in writing using the information below. We take all complaints seriously and will respond promptly.