Legal
HIPAA Notice of
Privacy Practices
This notice describes how medical and dental information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
Effective Date: February 16, 2026
Your Privacy Is Protected by Federal Law. Protected health information (PHI) about you is maintained as a written and/or electronic record of your contacts or visits for healthcare services with our practice. Specifically, PHI is information about you, including demographic information (i.e. name, address, phone, etc.), that may identify you and relates to your past, present, or future physical or mental health condition and related healthcare services. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires us to maintain the confidentiality of your PHI and to provide you with this Notice of our legal duties and privacy practices. We are required to follow the terms of the Notice currently in effect.
Your Rights Under the Privacy Rule
Following is a statement of your rights under the Privacy Rule. Please feel free to discuss any questions with our staff.
Right to Receive This Notice. You have the right to receive, and we are required to provide you with, a copy of this Notice of Privacy Practices. We reserve the right to change the terms of our notice at any time. Upon request, we will provide you with a revised copy, and the current Notice will also be posted in a conspicuous location within the practice and on our website.
Right to Authorize Other Use and Disclosure. You have the right to authorize any use or disclosure of PHI that is not specified within this Notice, for example marketing purposes, most uses of psychotherapy notes, or the sale of your PHI. You may revoke an authorization at any time, in writing, except to the extent that we have already taken action in reliance on it.
Right to Request an Alternative Means of Confidential Communication. You have the right to ask us to contact you about medical matters using an alternative method (i.e. email, telephone) and to an alternative destination (i.e. cell phone number, alternative address) designated by you. Requests must be made to us in writing, and we will follow all reasonable requests. This includes email or mobile text messaging, which carry inherent risks to the security and confidentiality of information sent and received; we cannot guarantee this security and will not be liable for inadvertent disclosure if you consent to being contacted this way.
Right to Inspect and Copy Your PHI. You may inspect and obtain a copy of your complete health record, including in electronic format if your record is maintained electronically. We have the right to charge a reasonable fee for paper or electronic copies as established by professional, state, or federal guidelines.
Right to Request a Restriction of Your PHI. You may ask us, in writing, not to use or disclose any part of your PHI for treatment, payment, or healthcare operations purposes. We are not required to agree except in limited circumstances specified by law, such as when the restriction concerns a treatment or service you, or someone on your behalf, has paid for in full, out of pocket.
Right to Request an Amendment. You may request an amendment to your protected health information for as long as we maintain it. In certain cases, we may deny your request and will notify you in writing.
Right to a Disclosure Accounting. You may request a listing of disclosures we have made of your PHI to entities or persons outside of our office, other than for treatment, payment, and healthcare operations.
Right to Receive a Privacy Breach Notice. You have the right to receive written notification if the practice discovers a breach of your unsecured PHI and determines, through a risk assessment, that notification is required.
How We May Use or Disclose Your Health Information
Following are examples of uses and disclosures of your protected health information that we are permitted to make. These examples are not meant to be exhaustive, but describe possible types of uses and disclosures.
Treatment. We may use and disclose your PHI to provide, coordinate, or manage your healthcare and any related services, including coordination with a pharmacy that would fill your prescriptions or with other healthcare providers involved in your care and treatment.
Special Notices. We may use or disclose your PHI, as necessary, to remind you of your appointment or to provide information that describes or recommends treatment alternatives regarding your care, health related benefits and services, or fundraising activities. You have the right to opt out of such special notices, and each notice will include instructions for opting out.
Payment. Your PHI will be used, as needed, to obtain payment for your healthcare services, including activities your health insurance plan may undertake before it approves or pays for the services we recommend, such as determining eligibility or coverage for insurance benefits.
Healthcare Operations. We may use or disclose your PHI, as needed, to support the business activities of our practice, including business planning and development, quality assessment and improvement, medical review, legal services, auditing functions, and patient safety activities.
Health Information Organization. The practice may elect to use a health information organization, or other such organization, to facilitate the electronic exchange of information for treatment, payment, or healthcare operations.
To Others Involved in Your Healthcare. Unless you object, we may disclose to a member of your family, a close friend, or any other person you identify, PHI that directly relates to that person's involvement in your healthcare. We may also disclose PHI to notify or assist in notifying a family member, personal representative, or another responsible person of your condition, using our professional judgment to determine what is in your best interest.
As Required by Law. We are also permitted to use or disclose your PHI without written authorization for purposes such as: public health activities; health oversight activities; cases of abuse or neglect; Food and Drug Administration requirements; research, legal, or law enforcement purposes; coroners and funeral directors; organ donation; military and national security activities; worker's compensation; correctional facilities; and if requested by the Department of Health and Human Services to investigate our compliance with the Privacy Rule.
Substance Use Disorder Records (42 CFR Part 2). Records relating to substance use disorder treatment are protected under federal law (42 CFR Part 2). These records may not be used or disclosed without your specific written consent except as expressly permitted by law, and cannot be used in civil, criminal, administrative, or legislative proceedings without a valid court order.
Patient's Bill of Rights and Responsibilities
Section 381.026, Florida Statutes
A Patient Has the Right To:
- Be treated with courtesy and respect, with appreciation of his or her dignity, and with protection of privacy.
- Receive a prompt and reasonable response to questions and requests.
- Know who is providing medical services and is responsible for his or her care.
- Know what patient support services are available, including whether an interpreter is available if the patient does not speak English.
- Know what rules and regulations apply to his or her conduct.
- Be given information such as diagnosis, planned course of treatment, alternatives, risks, and prognosis by the healthcare provider.
- Refuse any treatment, except as otherwise provided by law.
- Be given full information and necessary counseling on the availability of known financial resources for care.
- Know whether the healthcare provider or facility accepts the Medicare assignment rate, if the patient is covered by Medicare.
- Receive, prior to treatment, a reasonable estimate of charges for medical care.
- Receive a copy of an understandable itemized bill and, if requested, to have the charges explained.
- Receive medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
- Receive treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
- Know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such research.
- Express complaints regarding any violation of his or her rights.
A Patient Is Responsible For:
- Giving the healthcare provider accurate information about present complaints, past illnesses, hospitalizations, medications, and any other information about his or her health.
- Reporting unexpected changes in his or her condition to the healthcare provider.
- Reporting to the healthcare provider whether he or she understands a planned course of action and what is expected of him or her.
- Following the treatment plan recommended by the healthcare provider.
- Keeping appointments and, when unable to do so, notifying the healthcare provider or facility.
- His or her actions if treatment is refused or if the patient does not follow the healthcare provider's instructions.
- Making sure financial responsibilities are carried out.
- Following healthcare facility conduct rules and regulations.
Our Duties
We are required by law to:
- Maintain the confidentiality of your protected health information.
- Provide you with this Notice of our legal duties and privacy practices.
- Follow the terms of the Notice currently in effect.
- Notify you if there is a breach of unsecured PHI.
We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all PHI that we maintain. Revised Notices will be made available in our office and on our website.
How to Exercise Your Rights or File a Complaint
To exercise any of your rights under this Notice, or if you believe your privacy rights have been violated, please contact our Privacy Officer in writing:
Privacy Officer
Dental Implants & Cosmetics
201 North University Drive, Suite 101
Plantation, Florida 33324
954-933-6825You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by visiting hhs.gov/hipaa. We will not retaliate against you for filing a complaint.