Your rights
You have the right to:
- Get a copy of your dental record
- Correct information in your record
- Request confidential communication
- Ask us to limit what we share
- Get a list of those we have shared with
- Get a copy of this notice
- Choose someone to act for you
- File a complaint
Your choices
You have some choices in how we use and share information as we:
- Tell family and friends about your care
- Provide disaster relief
- Market our services or sell information, which we never do without your written permission
Our uses and disclosures
We may use and share your information as we:
- Treat you
- Run our practice
- Bill for your services
- Help with public health and safety
- Do research
- Comply with the law
- Respond to government, legal, and workers’ compensation requests
Your rights
When it comes to your health information, you have certain rights. This section explains them and some of our responsibilities in helping you use them.
Get an electronic or paper copy of your record
- You can ask to see or get a copy of your dental record and other health information we hold about you. Ask us how.
- We will provide a copy or a summary, usually within 15 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your record
- You can ask us to correct health information you believe is incorrect or incomplete.
- We may say no, but we will tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way, such as a mobile number or a different mailing address.
- We will say yes to all reasonable requests.
Ask us to limit what we use or share
- You can ask us not to use or share certain information for treatment, payment, or our operations. We are not required to agree, and we may say no if it would affect your care.
- If you pay for a service in full out of pocket, you can ask us not to share that information with your health plan for payment or operations. We will say yes unless a law requires us to share it.
Get a list of those we have shared information with
- You can ask for a list (an accounting) of the times we have shared your health information in the six years before your request, who we shared it with, and why.
- The list will include all disclosures except those for treatment, payment, and health care operations, and certain others, such as any you asked us to make. We provide one list a year free and may charge a reasonable, cost-based fee for another within 12 months.
Get a copy of this notice
- You can ask for a paper copy at any time, even if you agreed to receive it electronically. We will provide it promptly.
Choose someone to act for you
- If you have given someone medical power of attorney, or someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will confirm the person has this authority before we act.
File a complaint if you feel your rights are violated
- You can complain to us using the contact details in Questions and complaints.
- You can also complain to the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue, S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or at hhs.gov/ocr/complaints (opens in a new tab).
- We will not retaliate against you for filing a complaint.
Your choices
For certain health information, you can tell us what you want us to share. If you have a clear preference in the situations below, tell us and we will follow your instructions. You have both the right and the choice to tell us whether to:
- Share information with family, close friends, or others involved in your care
- Share information in a disaster relief situation
If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest. We may also share it when needed to lessen a serious and imminent threat to health or safety.
We never share your information in these cases unless you give us written permission:
- Marketing
- Sale of your information, except as part of a sale or merger of the practice
- Substance use disorder treatment information in your record
Our uses and disclosures
We typically use or share your health information in the following ways.
To treat you
We can use your health information and share it with other professionals who are treating you. For example, we send treatment reports and images to the general dentist who referred you, or consult your physician before a surgical procedure.
To run our practice
We can use and share your health information to run the practice, improve your care, and contact you when necessary. We may use outside services, including software that helps with appointment reminders, patient messages, scheduling, and documentation. Each one has an agreement with us requiring it to follow privacy and security law.
To bill for your services
We can use and share your health information to bill and get payment from health plans or other entities. For example, we give your dental insurance plan the information it needs to pay for your treatment.
Other ways we may use or share your information
We are allowed or required to share your information in other ways, usually ones that contribute to the public good, such as public health and research. We must meet conditions set by law before we do. More detail is available at hhs.gov/hipaa/for-individuals (opens in a new tab).
- Public health and safety: preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.
- Research: we can use or share your information for health research.
- Complying with the law: we share information when state or federal law requires it, including with the Department of Health and Human Services if it wants to confirm we are complying with federal privacy law.
- Organ and tissue donation: we can share information with organ procurement organizations.
- Medical examiners and funeral directors: we can share information when an individual dies.
- Workers’ compensation, law enforcement, and government requests: for workers’ compensation claims, for law enforcement purposes, with health oversight agencies for activities authorized by law, and for special government functions such as military and national security.
- Lawsuits and legal actions: in response to a court or administrative order, or a subpoena.
Our responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will not send you unsecured email containing your protected health information without your informed consent.
- We will tell you promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. You may change your mind at any time by letting us know in writing.
- We comply with California law, including the Confidentiality of Medical Information Act, which places further limits on how we use and share your information. For example, we will not share information about treatment for mental health, substance use, abortion, contraception, or gender-affirming care without your written consent, except as the law allows.
Changes to this notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office, and on this website.
Aloe Endodontics does not market or sell your personal information.
Questions and complaints
If you would like more information about our privacy practices, or have questions or concerns, please contact our Privacy Officer.
- Privacy Officer
- Aloe Endodontics
- Telephone
- (714) 900-3655
- hello@aloeendo.com
- Address
- 652 S Brea Blvd, Brea, CA 92821
If you believe we may have violated your privacy rights, or you disagree with a decision we made about access to your information or about a request to amend, restrict, or confidentially communicate it, you may send a written complaint to our office or to the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201. You can also call 1-877-696-6775 or visit hhs.gov/ocr/complaints (opens in a new tab). We will not retaliate against you for filing a complaint.