NOTICE OF PRIVACY PRACTICES

This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

Effective Date: February 12, 2026

Our Responsibility

We take our responsibility to safeguard your Protected Health Information (PHI) very seriously. We value your trust as an important part of our ability to provide you with the best possible medical care. We are dedicated to defending your right to a confidential relationship with your provider.

We are required by law to maintain the privacy and security of your PHI. We must provide you with this Notice and follow the privacy practices that are described in it while it is in effect. 

This Notice takes effect on the date set forth at the top of this page and will remain in effect until it is replaced. We reserve the right at any time to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. Any changes made will apply to all PHI we maintain. If such changes occur, we will make the revised Notice available at our office and on our website, copies will be available upon request.  

We are required by law to notify you of any breach following unauthorized acquisition, access or disclosure of your unsecured PHI. 

How We May Use and Disclose Your Protected Health Information (PHI)

• Treatment: To provide, coordinate or manage your dental care and related services with other providers or facilities.
• Payment: To bill and collect payment from your insurance plans or other responsible parties for services provided. 
• Healthcare Operations: To improve our services, manage our practice, staff training, audits, licensing and administrative activities. 

Other Permitted or Required Uses and Disclosures

We may also disclose your PHI without your authorization in the following circumstances, as permitted or required by law:

• Legal Requirements: To comply with federal, state or local laws, court orders, subpoenas, or lawful processes. 
• Health Oversight Activities: For audits, investigations, inspections, or licensing activities conducted by health oversight agencies.
• Public Health and Safety: Including disease reporting and vital statistics, abuse and neglect reporting, injury prevention and FDA oversight. 
• Serious Threats: To prevent or lessen a serious threat to your health or safety or that of others.  
• Research: When approved through required processes. 
• Coroners, Medical Examiners, Funeral Directors and Organ/Tissue Donation: To identify a deceased person, determine cause of death or facilitate donation.
• Workers’ Compensation: As required by workers’ compensation or similar programs. 

We will make reasonable efforts to limit disclosures to the minimum necessary for the intended purpose. 

Family, Friends and Others Involved in Your Care: We may disclose your health information to family members, friends, or others involved in your care or payment for care, as permitted by law. Such disclosures will be limited to information relevant to their involvement and will be made with your verbal permission, if you do not object when given the opportunity, or when we can reasonably infer that you would not object.

If you are unable to give consent due to absence, incapacity, or a medical emergency, we may, in our professional judgment, disclose relevant health information to those involved in your care when we believe it is in your best interest.

Plan Sponsors: If your dental insurance coverage is through an employer’s sponsored group dental plan, we may share summary health information with the plan sponsor. 

Appointment Reminders: We may contact you by phone, voicemail, email, postcard or letter to remind you of appointments or provide information related to your care. By providing your contact information to us, you agree that you may receive such communications, including reminders and breach notifications via email as a possible alternative to US Mail. It is the policy of our office to leave a message on any voicemail or answering machine that may be attached to a number that you provide (home, cell or work). 

Health Related Products and Services: We may use your medical information to communicate with you about health-related products, benefits, services, payment for those products and services and treatment alternatives. 

Marketing Health-Related Services: We will not use or disclose your PHI for marketing or fundraising without your written authorization. You may revoke this authorization at any time in writing. We will not sell your PHI to another organization for marketing or any other purposes.

Information Not Personally Identifiable:  We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.

Business Associates: We may disclose your PHI to business associates who perform services for us, provided they agree to safeguard your information. 

Uses and Disclosures Requiring Authorization

We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific written authorization. We must obtain your authorization separate from any consent we may have obtained from you.

If you give us authorization to use or disclose PHI about you, you may revoke that authorization in writing at any time.

If you revoke your authorization, we will no longer use or disclose information about you for the reasons covered by your written authorization. However, we cannot take back any uses or disclosures already made with your permission.

Additional Restrictions on Use and Disclosure 

Certain federal and state laws may require special privacy protections that restrict the use and disclosure of certain health information, including highly confidential information about you. Highly Confidential Information may include:

• HIV/AIDS and HIV Testing Information (ORS 433.045)
• Mental Health Treatment Information (ORS 179.505–179.509)
• Genetic Information (ORS 192.531–192.549)
• Substance Use Disorder (SUD) Records (42 CFR Part 2),
• Reproductive Health Information

Reproductive Health Records

In compliance with the HHS Reproductive Health Privacy Rule, we will ensure that any uses or disclosures of your protected health information (PHI) related to reproductive health will not interfere with your rights under this rule. We will provide adequate notice of the uses and disclosures of such records and will adhere to all applicable legal protections to maintain the confidentiality and privacy of your reproductive health information.

Substance Use Disorder (SUD) Records

Substance Use Disorder (SUD) Treatment records have enhanced protections under federal law (42 CRF Part 2). They cannot be used in legal proceedings without your written consent or court order.

If the use or disclosure of health information described above in this notice is prohibited or materially limited by other laws that apply to us, it is our intent to meet the requirements of the more stringent law.

Your Rights

You have rights to: 

• Access. Inspect or obtain copies of your PHI. Fees may apply for copying or mailing physical copies, however digital copies can be requested, if readily producible. 
• Amend. Request corrections of your PHI. We may deny requests under certain circumstances. 
• Request Restrictions. Ask us to limit uses or disclosures of your PHI. We are not required to agree. You have the right to request that we not disclose information about a service to your health plan if you pay for that service in full out of pocket. We must agree to this request unless disclosure is required by law. 
• Confidential Communications. Request alternative communication methods or locations. 
• Paper Copy of This Notice. Obtain a paper copy of this Notice at any time. 
• Accounting of Disclosures. Request a list of certain disclosures made outside treatment, payment and operations. 
• Breach Notifications. Be notified if a breach occurs that may have compromised your PHI. 
• File a Complaint. You have the right to file a complaint with our Privacy Officer or file a complaint with the US Government. You will not be retaliated against for filing a complaint. 

Complaints 

If you are concerned that we may have violated your privacy rights, you may contact our Privacy Officer to register either a verbal or written complaint.  You may also submit a written complaint to:

United States Department of Health and Human Services
Office for Civil Rights
 200 Independence Avenue, SW, Room 509F, 
Washington, DC, 20201. 
You may contact the Office for Civil Rights’ hotline at 1-800-368-1019.  

We support your right to privacy of your medical information. You will not be retaliated against in any way if you choose to file a complaint with us or with the US Department of Health and Human Services.