Effective Date: May 7, 2026

Edgewood Sedation Center

Notice of Privacy Practices

This Notice Describes How Medical Information About You May Be Used and Disclosed and How You Can Get Access to This Information. Please Review It Carefully.

I. Dental Practice Covered by this Notice

This Notice describes the privacy practices of Edgewood Sedation Center (“Dental Practice”). “We” and “our” means the Dental Practice. “You” and “your” means our patient.

II. How to Contact Us / Our Privacy Official

If you have any questions or would like further information about this Notice, you can contact Edgewood Sedation Center Privacy Official at:

[email protected]

III. Our Promise to You and Our Legal Obligations

The privacy of your health information is important to us. We understand that your health information is personal and we are committed to protecting it.

This Notice describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information.

Protected health information is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

We are required by law to:

• Maintain the privacy of your protected health information;
• Provide you with this Notice of our legal duties and privacy practices; and
• Abide by the terms of the Notice currently in effect.

IV. Last Revision Date

This Notice was last revised on August 1, 2021.

V. How We May Use or Disclose Your Health Information

The following examples describe different ways we may use or disclose your health information. These examples are not meant to be exhaustive.

We are permitted by law to use and disclose your health information for the following purposes:

A. Common Uses and Disclosures

• Treatment: We may use your health information to provide dental treatment or services and disclose information to specialists, physicians, or other healthcare professionals involved in your care.
• Payment: We may use and disclose your health information to obtain payment from health plans and insurers.
• Health Care Operations: We may use and disclose your health information for activities necessary to operate our practice, including quality assurance, audits, staff training, and business planning.
• Appointment Reminders: We may contact you by phone, voicemail, postcard, text message, or email to remind you of appointments.
• Treatment Alternatives and Benefits: We may inform you about treatment options, alternatives, and health-related benefits or services.
• Family and Friends: We may disclose your health information to family members or friends involved in your care or payment for your care when appropriate.
• Business Associates: We may share your protected health information with third-party service providers who perform services on our behalf and are contractually required to safeguard your information.

B. Less Common Uses and Disclosures

• Disclosures Required by Law: We may disclose health information when required by federal, state, or local law.
• Public Health Activities: We may disclose health information for public health purposes, including disease prevention and reporting.
• Victims of Abuse or Neglect: We may disclose health information to appropriate government authorities when abuse, neglect, or domestic violence is suspected.
• Health Oversight Activities: We may disclose health information to agencies responsible for oversight of the healthcare system.
• Lawsuits and Legal Actions: We may disclose health information in response to court orders, subpoenas, or lawful legal processes.
• Law Enforcement: We may disclose health information for certain law enforcement purposes.
• Coroners and Funeral Directors: We may disclose health information to coroners, medical examiners, and funeral directors as required.
• Organ and Tissue Donation: We may disclose health information for organ, eye, or tissue donation purposes.
• Research: We may use or disclose health information for approved research purposes.
• Threats to Health or Safety: We may disclose information to prevent or reduce a serious threat to health or safety.
• Specialized Government Functions: We may disclose information for military, national security, correctional institution, or protective services purposes.
• Workers’ Compensation: We may disclose health information to comply with workers’ compensation laws.

VI. Your Written Authorization for Other Uses and Disclosures

Uses and disclosures involving psychotherapy notes, marketing, sale of protected health information, or other uses not described in this Notice will only be made with your written authorization unless otherwise permitted or required by law.

You may revoke your authorization at any time in writing, except to the extent we have already relied upon it.

VII. Your Rights Regarding Your Health Information

You have the following rights regarding your health information:

• Right to Access and Review: You may request access to or copies of your health information.
• Right to Amend: You may request corrections to your health information if you believe it is inaccurate or incomplete.
• Right to Restrict Use and Disclosure: You may request limitations on how we use or disclose your health information.
• Right to Confidential Communications: You may request communications by alternative means or locations.
• Right to an Accounting of Disclosures: You may request a list of certain disclosures made within the previous six years.
• Right to a Paper Copy: You may request a paper copy of this Notice at any time.
• Right to Breach Notification: You have the right to be notified if your protected health information is compromised in a data breach.

VIII. Special Protections for Certain Information

Certain federal and state laws may provide additional privacy protections for HIV-related information, alcohol and substance abuse treatment records, mental health information, and genetic information.

IX. Changes to This Notice

We reserve the right to change this Notice and our privacy practices at any time. Any revisions will apply to all health information we maintain.

Updated versions of this Notice will be posted in our office and on our website, if applicable.

The effective date of this Notice is 05/01/2020.

X. How to Make Privacy Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Official or with the U.S. Department of Health and Human Services, Office for Civil Rights.

We will not retaliate against you for filing a complaint.

XI. Ensuring Your Information Remains Confidential

No mobile information will be shared with third parties or affiliates for marketing or promotional purposes.

All other categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.