HIPAA Notice of Privacy Practices
Effective date: February 16, 2026
This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
We reserve the right to change our privacy practices and the terms of this Notice at any time, as permitted by law. Any revised Notice will apply to all protected health information we maintain—past, present, and future. We will post the current Notice in our office and on our website. A paper copy is available at the front desk at no charge. Material changes will be communicated as required by law.
How we may use and disclose your information
Not every possible use is listed. All uses will fall within these categories or will otherwise be permitted or required by law.
Treatment
We may use and disclose your protected health information to provide, coordinate, or manage dental care, including sharing information with other providers involved in your care, planning treatment, and obtaining referrals.
Payment
We may use and disclose protected health information to obtain payment for services, verify insurance coverage, submit claims, and work with third parties that assist with billing.
Health care operations
We may use and disclose protected health information for quality improvement, staff training, credentialing, audits, and legal or compliance services.
Appointment reminders and related communications
We may contact you by phone, text, email, postcard, or letter with appointment reminders and information about treatment options or related services. Reasonable written requests for a preferred contact method will be honored.
Other uses and disclosures permitted or required by law
We may use or disclose protected health information as allowed or required by federal and state law, including when required by law; for public-health activities; to report abuse, neglect, or domestic violence; for health-oversight activities; in response to lawful legal process; to coroners, medical examiners, and funeral directors; for organ and tissue donation; for approved research; to avert a serious and imminent threat; for specialized government functions; and as authorized by workers’ compensation laws.
Special protections for certain information
Some information is subject to additional federal or state protections. Where required, we will obtain written permission or follow the additional limits that apply. Specially protected categories may include HIV/AIDS-related information, genetic information, mental-health and psychotherapy records, and substance-use-disorder treatment information.
Substance use disorder records — 42 CFR Part 2
Springs Dental is not a federally assisted substance-use-disorder treatment program, but may receive protected records from another provider while coordinating care. Records received under a general consent may be used and disclosed for treatment, payment, and health care operations as permitted by HIPAA and Part 2. Records received under a specific consent will be used only as expressly authorized unless otherwise required by law.
Part 2 records and testimony describing them will not be used in proceedings against you unless authorized by your consent or a qualifying court order. Any redisclosure will be limited and accompanied by required confidentiality notices. Where Part 2 is more protective than HIPAA, the more protective standard will apply.
Uses requiring written authorization
For uses and disclosures not described in this Notice, we will obtain your written authorization. You may revoke an authorization in writing at any time. Written authorization is generally required for most uses and disclosures of psychotherapy notes, most marketing, the sale of protected health information, and any other use not otherwise permitted or required by law.
Your rights regarding health information
To exercise any of these rights, submit a written request to our Privacy Officer.
Access your records
You may inspect and obtain a copy of protected health information we maintain about you, with limited exceptions. Electronic copies will be provided when readily available. A reasonable cost-based fee may apply.
Request an amendment
If you believe information is incomplete or inaccurate, you may request an amendment in writing. If a request is denied, we will explain the decision and available options.
Accounting of disclosures
You may request a list of certain disclosures made during the past six years, excluding disclosures for treatment, payment, and health care operations. The first request in a 12-month period is free.
Request restrictions
You may ask us to limit how protected information is used or disclosed. We must honor a restriction when disclosure is to a health plan for payment or operations, the information relates solely to a service paid in full, and disclosure is not otherwise required by law.
Confidential communications
You may request contact through a specific method, address, or phone number. Reasonable requests will be accommodated.
Paper copy and breach notice
You may request a paper copy of this Notice at any time. You also have the right to written notice of a breach of unsecured protected health information as required by federal law.
Complaints without retaliation
You will not be penalized, denied care, or retaliated against for exercising these rights or filing a complaint.
Questions and complaints
If you have questions about privacy rights or believe your rights have been violated, contact:
Privacy Officer, Springs Dental
1215 S Fort Apache Rd., Suite 110
Las Vegas, NV 89117
(702) 766-7779
You may also file a complaint with the U.S. Department of Health & Human Services, Office for Civil Rights, at hhs.gov/ocr/privacy or 1-800-368-1019 (TTY: 1-800-537-7697). You will not be retaliated against for filing a complaint.
Acknowledgment of receipt
A copy of this Notice will be provided to each patient at or before the first date of service. You may be asked to sign a separate acknowledgment confirming receipt. Prepared in accordance with 45 C.F.R. §164.520 and 42 C.F.R. Part 2, as amended. This document does not constitute legal advice.