THIS NOTICE DESCRIBES HOW MEDICAL/DENTAL INFORMATION ABOUT YOU/YOUR
CHILD (OR OTHER PERSON YOU MAY BE LEGALLY RESPONSIBLE FOR) MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
REVIEW IT CAREFULLY.
The law requires us to keep your dental records confidential and to provide you with this Notice of Privacy
Practices describing how we may use and disclose your health information, including your dental history,
symptoms, examination, diagnoses and treatment plans, to carry out treatment, payment and health care
operations and for other purposes that are allowed or required by law. It also describes your rights to review
and control the use and disclosure of your health information.
We are required to follow the privacy practices described in this Notice. We may change our privacy
practices at any time. The revised privacy practices will be set forth in a revised Notice and will be
effective for all health information that we maintain at that time. Upon your request, we will provide you
with a copy of the most recent Notice. A current copy of our Notice of Privacy Practices will be posted in
our office in a visible location at all times.