Notice of Privacy Practices
This notice describes how health information about you may be used and disclosed and how you can get access to it. Please review it carefully.
Effective date: October 18, 2026
Simply Smiles, 2750 Stickney Point Rd, Suite 107, Sarasota, FL 34231, is required by law to keep your health information private, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
How We May Use and Disclose Your Health Information
We may use and share your health information without your written authorization for the following purposes.
Treatment. We use your information to provide your dental care and may share it with other providers involved in your care, such as a specialist or a dental laboratory.
Payment. We may use and share information to bill and collect payment for your care, for example by sending a claim to your dental insurance plan.
Health care operations. We may use information to run our practice, including quality review, staff training, scheduling and business planning.
Appointment reminders and care information. We may contact you with reminders, follow-up instructions or information about treatment options.
People involved in your care. With your agreement, or when you do not object, we may share relevant information with a family member or other person who helps with your care or payment for it.
Business associates. We may share information with outside companies that perform services for us. They must protect it.
Other Uses and Disclosures Permitted or Required by Law
When a federal, state or local law requires it.
For public health activities, such as reporting certain diseases, injuries or problems with products.
To report suspected abuse, neglect or domestic violence to the proper authorities.
To health oversight agencies for audits, inspections and licensing.
In response to a court order, subpoena or other lawful process.
To law enforcement officials as allowed by law.
To prevent a serious threat to the health or safety of a person or the public.
For workers' compensation, military, national security and similar government functions as authorized by law.
Uses That Require Your Written Authorization
We will ask for your written authorization before we use or share your health information for most marketing purposes, before any sale of your health information and for other uses not described in this notice. You may revoke an authorization in writing at any time.
Where Florida law gives your health information more protection than federal law, we follow the more protective rule.
Your Rights
See and get a copy. You may ask to see or receive a copy of your dental and billing records. We may charge a reasonable, cost-based fee.
Ask for a correction. If you believe information in your record is incorrect or incomplete, you may ask us in writing to amend it.
Request confidential communications. You may ask us to contact you in a specific way or at a specific address or phone number. We will agree to reasonable requests.
Ask us to limit what we share. You may ask us to restrict certain uses or disclosures. We are not required to agree in every case. If you pay for a service in full out of pocket, you may ask us not to share information about that service with your health plan, and we will agree unless a law requires the disclosure.
Get a list of disclosures. You may request an accounting of certain disclosures we made in the six years before your request.
Receive a paper copy of this notice. You may ask for a paper copy at any time, even if you agreed to receive it electronically.
Be notified of a breach. We will notify you if a breach occurs that may have compromised the privacy or security of your unsecured health information.
Choose someone to act for you. A person with legal authority, such as a guardian or someone holding a health care power of attorney, may exercise your rights on your behalf.
To use any of these rights, contact our Privacy Officer.
Our Duties
We are required by law to maintain the privacy and security of your health information.
We must follow the practices described in this notice and give you a copy of it.
Changes to This Notice
We may change this notice, and the changes will apply to all the health information we hold. The current notice will be available in our office and on this website.
Questions and Complaints
If you have questions or believe your privacy rights have been violated, contact our Privacy Officer: [Confirm with office: Privacy Officer name and contact]. You may also call our office at (941) 877-5262.
You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
