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HIPAA 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.
 

Elite Smile Dental Hygiene Practice of Laurie Tolosa is committed to protecting the privacy and confidentiality of your protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

We may use and disclose your health information for purposes including:
 

  • Treatment coordination

  • Appointment reminders

  • Payment and insurance billing

  • Healthcare operations

  • Legal and regulatory compliance
     

We will not use or disclose your information for purposes not described in this notice without your written authorization, except as permitted or required by law.
 

You have the right to:
 

  • Request access to your records

  • Request corrections to your records

  • Request restrictions on disclosures

  • Receive confidential communications

  • Obtain a copy of this notice
     

If you believe your privacy rights have been violated, you may file a complaint without fear of retaliation.

For questions regarding this notice, please contact:
 

Elite Smile Dental Hygiene Practice of Laurie Tolosa
Phone: (408) 829-2219
Email: hello@elitesmilehygiene

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