HIPAA Notice
How we may use and disclose your health information. Effective 2026-05-14.
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 duties
Sycamore Dental is required by the Health Insurance Portability and Accountability Act (HIPAA) to maintain the privacy of your Protected Health Information (PHI). We are required to provide this notice, to follow the terms of the notice currently in effect, and to notify you in the event of a breach of unsecured PHI.
How we may use your information
- Treatment. To provide and coordinate dental care, including sharing with other providers involved in your treatment (e.g. orthodontists, oral surgeons).
- Payment. To bill for services, submit claims to your insurance, and verify coverage.
- Operations. To run the practice — scheduling, quality reviews, training, audits.
Other permitted disclosures
Required reporting to public health authorities, law enforcement when legally compelled, in response to a valid court order, and to family or others involved in your care if you have authorized it.
Your rights
- Access. Inspect and copy your records. We respond within 30 days.
- Amend. Request a correction if you believe something is wrong.
- Restrict. Ask us to limit how we use or disclose your PHI. We will accommodate reasonable requests.
- Confidential communications. Tell us how you would like to be contacted (e.g. only by mobile, not at home).
- Accounting. Request a list of certain disclosures we have made.
- Paper copy. Request a paper copy of this notice at any time, even if you originally received it electronically.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us at hello@sycamoredentalnyack.example or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
Contact
Sycamore Dental, 248 Willowbank Avenue, Nyack, NY 10960. (845) 555-0182.