Notice of privacy practices

In short

This notice describes how a dental practice may use and share your health information, and how you can get access to it. Please read it carefully. Brisa Family Dental is fictional, so this is an example of what a real notice under the federal privacy law known as HIPAA looks like. A real practice has its own notice reviewed by a lawyer.

How we may use and share your information

Without a separate written permission, the law lets a practice use and share your information for these purposes:

• Treatment. To care for you. For example, a dentist may share your records with a specialist you are referred to.
• Payment. To bill you or your insurance plan, and to check what your plan covers.
• Health care operations. To run the practice, such as quality reviews, training and scheduling.
• Appointment reminders. To contact you by phone, text or mail about visits, using the contact choices you give us.
• Required by law. To follow public health rules, court orders and other legal requirements.

When we need your written permission

For anything else, a practice asks you to sign an authorization first. Examples are marketing messages and sharing your records with an employer. You can cancel an authorization in writing at any time. Cancelling does not undo what was already shared while it was in effect.

Your rights

• See and copy your records. Ask in writing. A practice normally responds within 30 days.
• Ask for a correction. If something in your record is wrong, you can ask us to fix it.
• Ask for limits. You can ask us to limit how we use or share your information. We may say no, except when you pay in full out of pocket and ask us not to share the visit with your insurance plan.
• Choose how we contact you. For example, a different phone number or only by mail.
• Get a list of disclosures. You can ask who we shared your information with, apart from treatment, payment and operations.
• Get a paper copy of this notice. Even if you agreed to receive it by email.

Our duties

A practice must keep your health information private, give you this notice, follow what it says, and tell you if your information is affected by a breach. It can change its notice. If it does, the new version applies to all information it holds, and it posts the new notice in the office and on its website.

Complaints

If you think your privacy rights were not respected, you can tell the practice or file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be treated differently for filing a complaint.

Contact

Questions about this notice go to the privacy contact at the practice: Brisa Family Dental, Coral Way, Miami, FL 33145 (fictional address), phone(305) 555-0147. All of these details are fictional.

This notice took effect in October 2026. Also see the website privacy page.