Notice of Privacy Practices
Effective date: November 13, 2026
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.
Lakeview Family Dentistry is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other applicable laws to maintain the privacy of your Protected Health Information (PHI), to provide you with notice of our legal duties and privacy practices regarding PHI, and to abide by the terms of this Notice currently in effect.
What Is Protected Health Information
Protected Health Information (PHI) 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 healthcare services.
How We May Use and Disclose Your PHI
We may use and disclose your PHI for the following purposes without your authorization:
For treatment. We may use your PHI to provide, coordinate, and manage your dental care. This includes sharing information with other healthcare providers involved in your care, such as specialists to whom we refer you.
For payment. We may use and disclose your PHI to obtain payment for the dental services we provide. This includes activities such as determining eligibility for insurance coverage, billing, claims processing, and collection activities.
For healthcare operations. We may use and disclose your PHI for activities that support the operation of our practice, such as quality assessment, employee evaluation, training, licensing, and business management.
To you. We will disclose your PHI to you or your personal representative when requested.
As required by law. We may use and disclose your PHI when required to do so by federal, state, or local law.
For public health activities. We may disclose your PHI for public health activities, such as reporting diseases, vital events, and adverse reactions to medications.
For health oversight activities. We may disclose your PHI to health oversight agencies for activities authorized by law.
For judicial and administrative proceedings. We may disclose your PHI in response to a court order, subpoena, or other lawful process.
For law enforcement purposes. We may disclose your PHI to law enforcement officials for purposes such as identifying a suspect, fugitive, material witness, or missing person.
For research. We may use or disclose your PHI for research purposes under certain limited circumstances.
To avoid a serious threat to health or safety. We may disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of another person or the public.
For specialized government functions. We may disclose your PHI for specialized government functions such as military and veterans activities, national security, and intelligence activities.
Uses and Disclosures That Require Your Authorization
Other uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. You may revoke this authorization at any time in writing.
This includes:
- Most uses and disclosures of psychotherapy notes
- Uses and disclosures for marketing purposes
- Disclosures that constitute a sale of PHI
Your Rights Regarding Your PHI
You have the following rights regarding your PHI:
Right to inspect and copy. You have the right to inspect and copy your PHI that we maintain in a designated record set. To request inspection or copies, submit a written request to our office.
Right to request amendment. You have the right to request that we amend PHI that you believe is incorrect or incomplete. We may deny your request under certain circumstances.
Right to an accounting of disclosures. You have the right to request an accounting of certain disclosures we have made of your PHI in the six years prior to your request.
Right to request restrictions. You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request, except in limited circumstances.
Right to request confidential communications. You have the right to request that we communicate with you about your PHI in a specific manner or location.
Right to a paper copy of this Notice. You have the right to a paper copy of this Notice, even if you have agreed to receive it electronically.
Right to be notified of a breach. You have the right to be notified of any breach of your unsecured PHI.
Our Obligations
We are required by law to:
- Maintain the privacy of your PHI
- Provide you with this Notice of our legal duties and privacy practices regarding PHI
- Notify you following a breach of unsecured PHI
- Abide by the terms of the Notice currently in effect
Changes to This Notice
We reserve the right to change the terms of this Notice at any time. Any new Notice will be effective for all PHI we maintain at that time. We will post a copy of the current Notice in our office and on our website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Official or with the Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.
Contact for Privacy Concerns
If you have any questions about this Notice or wish to file a complaint, please contact our Privacy Official:
Sherry Connery, Privacy Official
Lakeview Family Dentistry
13728 Office Park Court
Hudson, FL 34667
Phone: (727) 863-9669
Email: sherry@lakeviewfd.net
This Notice of Privacy Practices is provided in compliance with HIPAA Privacy Rule requirements.