Notice of Privacy Practices

Your Privacy Rights Under HIPAA at Harmony Cosmetic Dentistry & Implants

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.

Our Commitment to Your Privacy

Harmony Cosmetic Dentistry & Implants is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of your protected health information, to provide you with this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. 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 dental health, the care you receive, or payment for that care.

How We May Use and Disclose Your Health Information

The following categories describe the ways we may use and disclose your protected health information without your written authorization.

For Treatment. We may use your health information to provide and coordinate your dental care, and we may share it with other providers, specialists, laboratories, or pharmacies involved in your treatment.

For Payment. We may use and disclose your health information to obtain payment for the services we provide, including billing your dental or medical insurance and verifying coverage and benefits.

For Health Care Operations. We may use and disclose your health information to support the business activities of our practice, such as quality assessment, staff training, scheduling, and administrative functions.

Appointment Reminders and Treatment Information. We may contact you to remind you of appointments or to tell you about treatment options or other health related services that may be of interest to you.

Individuals Involved in Your Care. With your agreement, we may share relevant information with a family member, friend, or other person you involve in your care or in payment for your care.

As Required by Law. We will disclose your health information when required to do so by federal, state, or local law, including for public health activities, reporting of abuse or neglect, health oversight, judicial proceedings, law enforcement purposes, and to avert a serious threat to health or safety.

Uses and Disclosures That Require Your Written Authorization

Other uses and disclosures of your health information not described above will be made only with your written authorization. This includes most uses and disclosures for marketing purposes, any sale of your health information, and most sharing of psychotherapy notes if any are maintained. You may revoke an authorization in writing at any time, after which we will no longer use or disclose your information for the reasons covered by that authorization, except to the extent we have already relied on it.

Your Rights Regarding Your Health Information

You have the following rights with respect to your protected health information:

Right to Inspect and Copy. You may inspect and request a copy of the health information we maintain about you. We may charge a reasonable fee for the cost of copying.
Right to Request an Amendment. You may request that we amend health information you believe is incorrect or incomplete. We may deny the request in certain circumstances and will explain the reason in writing.
Right to an Accounting of Disclosures. You may request a list of certain disclosures we made of your health information.
Right to Request Restrictions. You may request a restriction on how we use or disclose your health information. We are not required to agree to every request, except where the disclosure is for payment or operations and you have paid for the service in full out of pocket.
Right to Request Confidential Communications. You may request that we communicate with you in a specific way or at a specific location.
Right to a Paper Copy. You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
Right to Be Notified of a Breach. You have the right to be notified if a breach of your unsecured protected health information occurs.

Changes to This Notice

We reserve the right to change this notice and to make the revised notice effective for health information we already have as well as information we receive in the future. The current notice will be posted in our office and on our website with its effective date.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office using the contact information below, or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.

Contact Information

If you have questions about this notice or wish to exercise any of your rights, please contact our Privacy Officer:

Harmony Cosmetic Dentistry & Implants
9511 FM1488, Suite #1000, Magnolia, TX 77354
Phone: (832) 464-4454
Email: Contactus@harmonycosmeticdentistry.com

Effective Date: June 2026