Effective Date 02/16/2026 Publication Date 02/16/2026
This notice describes how medical information about you may be used and disclosed,and how you can gain access to this information. Please review it carefully.
DENTALMED ASSOCIATES
Protected health information (PHI), about you, is maintained as a written and/or electronic record of your contacts or visits forhealthcare 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 healthcareservices.
Our practice is required to follow specific rules on maintaining the confidentiality of your PHI, using your information, and disclosing orsharing this information with other healthcare professionals involved in your care and treatment. This Notice describes your rights toaccess and control your PHI. It also describes how we follow applicable rules and use and disclose your PHI to provide your treatment,obtain payment for services you receive, manage our healthcare operations and for other purposes that are permitted or required by law.
Your Rights Under The Privacy Rule
Following is a statement of your rights, under the Privacy Rule, in reference to your PHI. Please feel free to discuss any questions withour staff.
You have the right to receive, and we are required to provide you with, a copy of this Notice of Privacy Practices
We are required to follow the terms of this notice. We reserve the right to change the terms of our notice, at any time. Upon yourrequest, we will provide you with a revised Notice of Privacy Practices if you call our office and request that a revised copy be sent toyou in the mail or ask for one at the time of your next appointment. The Notice will also be posted in a conspicuous location within thepractice, and if such is maintained by the practice, on it’s web site.
You have the right to authorize other use and disclosure
This means you have the right to authorize any use or disclosure of PHI that is not specified within this notice. For example, we wouldneed your written authorization to use or disclose your PHI for marketing purposes, for most uses or disclosures of psychotherapy notes,or if we intended to sell your PHI. You may revoke an authorization, at any time, in writing, except to the extent that your healthcareprovider, or our practice has taken an action in reliance on the use or disclosure indicated in the authorization.
You have the right to request an alternative means of confidential communication
This means you have the right to ask us to contact you about medical matters using an alternative method (i.e., email, telephone), andto a destination (i.e., cell phone number, alternative address, etc.) designated by you. You must inform us in writing, using a formprovided by our practice, how you wish to be contacted if other than the address/phone number that we have on file. We will followall reasonable requests.
You have the right to inspect and copy your PHI
This means you may inspect, and obtain a copy of your complete health record. If your health record is maintained electronically, youwill also have the right to request a copy in electronic format. We have the right to charge a reasonable fee for paper or electroniccopies as established by professional, state, or federal guidelines.
You have the right to request a restriction of your PHI
This means you may ask us, in writing, not to use or disclose any part of your protected health information for the purposes of treatment,payment or healthcare operations. If we agree to the requested restriction, we will abide by it, except in emergency circumstanceswhen the information is needed for your treatment. In certain cases, we may deny your request for a restriction. You will have the rightto request, in writing, that we restrict communication to your health plan regarding a specific treatment or service that you, or someoneon your behalf, has paid for in full, out-of-pocket. We are not permitted to deny this specific type of requested restriction.
You may have the right to request an amendment to your protected health information
This means you may request an amendment of your PHI for as long as we maintain this information. In certain cases, we may deny your request.
You have the right to request a disclosure accountability
This means that you may request a listing of disclosures that we have made, of your PHI, to entities or persons outside of our office.
You have the 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 arisk assessment that notification is required.
If you have questions regarding your privacy rights, please feel free to contact our Privacy Manager. Contact information is provided onthe following page under Privacy Complaints.
How We May Use or Disclose Protected Health Information
Following are examples of uses and disclosures of your protected health information that we are permitted to make. These examplesare not meant to be exhaustive, but to 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. This includes thecoordination or management of your healthcare with a third party that is involved in your care and treatment. For example, we woulddisclose your PHI, as necessary, to a pharmacy that would fill your prescriptions. We will also disclose PHI to other Healthcare Providerswho may be involved in your care and treatment.
Special Notices
We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment. We may contact you by phone orother means to provide results from exams or tests and to provide information that describes or recommends treatment alternativesregarding your care. Also, we may contact you to provide information about health-related benefits and services offered by our office,for fund-raising activities, or with respect to a group health plan, to disclose information to the health plan sponsor. You will have theright to opt out of such special notices, and each such notice will include instructions for opting out.
Payment
Your PHI will be used, as needed, to obtain payment for your healthcare services. This may include certain activities that your healthinsurance plan may undertake before it approves or pays for the healthcare services we recommend for you such as, making adetermination of eligibility or coverage for insurance benefits.
Healthcare Operations
We may use or disclose, as needed, your PHI in order to support the business activities of our practice. This includes, but is not limitedto business planning and development, quality assessment and improvement, medical review, legal services, auditing functions andpatient safety activities.
Health Information Organization
The practice may elect to use a health information organization, or other such organization to facilitate the electronic exchange ofinformation for the purposes of treatment, payment, or healthcare operations.
To Others Involved in Your Healthcare
Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person, that you identify, your PHIthat directly relates to that person’s involvement in your healthcare. If you are unable to agree or object to such a disclosure, we maydisclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may useor disclose PHI to notify or assist in notifying a family member, personal representative or any other person that is responsible for yourcare, of your general condition or death. If you are not present or able to agree or object to the use or disclosure of the PHI, then yourhealthcare provider may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only thePHI that is necessary will be disclosed.
Other Permitted and Required Uses and Disclosures
We are also permitted to use or disclose your PHI without your written authorization for the following purposes: as required by law;for public health activities; health oversight activities; in cases of abuse or neglect; to comply with Food and Drug Administrationrequirements; research purposes; legal proceedings; law enforcement purposes; coroners; funeral directors; organ donation; criminalactivity; military activity; national security; worker’s compensation; when an inmate in a correctional facility; and if requested by theDepartment of Health and Human Services in order to investigate or determine our compliance with the requirements of the PrivacyRule.
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 usedor disclosed without your specific written consent except as expressly permitted by law. Such records cannot be used in civil, criminal,administrative, or legislative proceedings without a valid court order.
Privacy Complaints
You have the right to complain to us, or directly to the Secretary of the Department of Health and Human Services if you believe yourprivacy rights have been violated by us. You may file a complaint with us by notifying the Privacy Manager at:
We will not retaliate against you for filing a complaint.
Address: 12600 PEMBROKE RD, SUITE #314
City: MIRAMAR
State: FL
Zip Code: 33027
12600 Pembroke Road Suite-314 Miramar, FL, 33027
Dentalmed Associates6100 Glades Road Suite 210Boca Raton, FL 33434