This notice describes how health information about you may be used and disclosed and how you can get access to this information.
Please review it carefully.
The Privacy of your health information is important to us.
Our Legal Duty
We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect 01/01/03, and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request.
You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.
Uses and Disclosures of Health Information
Treatment: We may be use or disclose your child’s health information to a physician, hospital, dentist or other health care provider providing treatment to them or referring to us.
Payment: We may use and disclose your child’s health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.
Your Authorization: Unless you give us a written authorization, we cannot use or disclose your child’s health information for any reason except those described in this Notice.
To Your Family and Friends: We must disclose your child’s health information to you, as described in the Patient Rights section of this Notice. We may disclose your child’s health information to an alternate adult (grandparent, sibling, babysitter, etc.) if that person brings your child to their dental appointment. We may also disclose health information to a non-custodial parent or guardian, if required by court order or requested by you.
Marketing Health-Related Services: We will NOT use your child’s health information for marketing communications without your written authorization.
Required by Law: We may use or disclose your child’s health information when we are required to do so by law.
Appointment Reminders: We may use or disclose your child’s health information to provide you with appointment reminders (such as voicemail messages, postcards, or letters).
Patient Rights
You have the right to look at or get copies of your child’s health information. You may request that we provide photocopies. You have the right to request in writing, that we amend your child’s health information.
If you want more information about our privacy practices or have questions or concerns, please contact us. We support your right to the privacy of your child’s health information. You may choose to file a complaint with us or with the U.S. Department of Health and Human Services. (Address provided upon request).
Contact Officer: Cassandra Elkins, D.D.S.
Address: 15303 Huebner Road, Building #17, San Antonio, TX 78248
Telephone: 210-696-2563