Notice of Privacy Practices
Effective Date: 11/08/2024
Olive Tree Dental Care
5400 Biscayne Dr Ste. D, North Port, FL 34287
941.732.0503
Your privacy is important to us. This Notice of Privacy Practices explains how we may use and
share your Protected Health Information (PHI), your rights concerning your PHI, and our
responsibilities in protecting your information.
Your Rights
You have the right to:
1. Access Your Records: Request to see or get a copy of your dental records and other health
information. Fees may apply for copies.
2. Request Corrections: Ask us to correct incorrect or incomplete information in your dental records.
3. Request Confidential Communications: Ask us to contact you in a specific way (e.g., at a specific
phone number or by mail) or to send communications to another location.
4. Request Restrictions: Ask us not to use or share certain health information for treatment,
payment, or operations. We will consider your request but may not be able to agree if it affects your
care.
5. Receive a List of Disclosures: Request a report of instances where we shared your health
information, excluding disclosures for treatment, payment, and healthcare operations.
6. Obtain a Copy of This Notice: You can ask for a paper or electronic copy of this Notice at any
time.7. File a Complaint: If you believe your privacy rights have been violated, you can file a complaint
with us or the U.S. Department of Health and Human Services. We will not retaliate against you for
filing a complaint.
Our Responsibilities
- We are required by law to protect your health information.
- We will let you know promptly if a breach occurs that may compromise the privacy or security of
your information.
- We will follow the terms of this Notice and provide you with a copy upon request.
How We Use and Share Your Information
We may use or share your health information in the following ways:
1. Treatment: We may use your information to provide dental care services or share it with other
healthcare professionals involved in your care.
2. Payment: We may use or share your information to bill and collect payment from insurance
companies or other entities.
3. Healthcare Operations: We may use your information to improve our services, conduct training,
and ensure quality care.
4. Public Health and Safety: We may share information for public health reporting, preventing
disease, or reporting adverse reactions to medications.
5. Required by Law: We may share your information when required by federal, state, or local law.
6. Law Enforcement and Legal Proceedings: We may share information in response to a court order,
subpoena, or other lawful process.
7. Research: We may use or share your information for research purposes under specific conditions.
8. Business Associates: We may share your information with trusted third-party organizations that
assist with billing, data management, or other operational tasks. These entities must also protectyour privacy.
9. Appointment Reminders and Communication: We may use your contact information to remind you
of appointments or provide information about dental services.
Your Choices
You can let us know if you prefer:
- To restrict sharing information with family or friends involved in your care.
- To limit how we use or share information for certain purposes.
If you have preferences, inform us in writing, and we will do our best to accommodate your request.
Contact Information
If you have questions or need assistance regarding this Notice, please contact:
Olive Tree Dental Care
5400 Biscayne Dr Ste. D, North Port, FL 34287
941.732.0503
Changes to This Notice
We reserve the right to change this Notice at any time. Updated Notices will be posted on our
website and in our office. The new terms will apply to all PHI we maintain, including information
created or received before the change.
We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.