NOTICE OF PRIVACY PRACTICES

Dental Frontiers & Associates, PLLC                                    Effective Date: March 27, 2026

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.

OUR LEGAL DUTY

We are required by applicable federal and state law to maintain the privacy of your protected health information (PHI) and to provide you with this Notice of our legal duties and privacy practices. We must follow the terms of this Notice currently in effect.

We reserve the right to change our privacy practices and the terms of this Notice at any time. Any changes will apply to all health information we maintain. A revised Notice will be available upon request and on our website.

USES AND DISCLOSURES OF HEALTH INFORMATION

Treatment- We may use or disclose your health information to provide, coordinate, or manage your dental care.

Payment- We may use and disclose your health information to obtain payment for services we provide.

Healthcare Operations -We may use and disclose your health information for practice operations, including quality assessment, staff training, licensing, and credentialing.

SPECIAL PROTECTIONS FOR SUBSTANCE USE DISORDER (SUD) INFORMATION

Certain health information, including information related to substance use disorder (SUD) diagnosis, treatment, or referral, may be subject to additional federal confidentiality protections under 42 CFR Part 2.

We may use and disclose SUD-related information for treatment, payment, and healthcare operations if you provide a single written consent for such uses and disclosures.

Once disclosed pursuant to your consent, this information may be redisclosed by HIPAA-covered entities and their business associates in accordance with the HIPAA Privacy Rule.

However, federal law continues to prohibit the use or disclosure of SUD-related information in civil, criminal, administrative, or legislative proceedings against you without your specific written consent or a court order.

These protections apply even if SUD-related information is included within your general medical or dental record.

OTHER USES AND DISCLOSURES

Your Authorization- We will not use or disclose your health information for purposes other than those described in this Notice without your written authorization. You may revoke your authorization at any time in writing.

Family and Friends- We may disclose your health information to a family member or friend involved in your care if you agree or do not object.

Persons Involved in Care- We may use or disclose information to notify family or others responsible for your care regarding your condition or location.

Appointment Reminders -We may contact you via phone, voicemail, text message, email, or mail regarding appointments.

Marketing -We will not use your information for marketing purposes without your written authorization.

Required by Law -We may disclose your information when required by law.

Abuse, Neglect, or Domestic Violence -We may disclose information to authorities if required or permitted by law.

National Security and Law Enforcement -We may disclose information to authorized officials as required by law.

PATIENT RIGHTS

Access -You have the right to inspect and obtain copies of your health information. Reasonable, cost-based fees may apply.

Restrictions -You may request restrictions on how your information is used or disclosed. We are not required to agree.

Alternative Communication -You may request confidential communication by alternative means or locations.

Amendment -You may request corrections to your health information.

Electronic Notice -You have the right to receive a paper copy of this Notice.

QUESTIONS AND COMPLAINTS

If you have questions or concerns about this Notice or believe your privacy rights have been violated, you may contact:

Privacy Officer
Dr. Ellie Doh
 Dental Frontiers & Associates, PLLC
 13312 Theis Lane
 Tomball, TX 77375
 Phone: 281-516-7272
 Email: dentalfrontiers457@gmail.com

You may also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.