Notice of Privacy Practices

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.

1. Dental Practice Covered by this Notice This Notice describes the privacy practices of Lakehouse Dental. “We” and “our” means the Dental Practice. “You” and “your” means our patient.

2. How to Contact Us / Our Privacy Official If you have any questions or would like further information about this Notice, you can contact: Lakehouse Dental’s Privacy Official at: Phone: 704-887-2744 Email: info@lakehousedentist.com

3. Our Promise to You and Our Legal Obligations
   3.1 The privacy of your health information is important to us. We understand that your health information is personal and we are committed to protecting it.

   3.2 This Notice describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes permitted or required by law. It also describes your rights to access and control your protected health information.

   3.3 Protected health information is information about you, including demographic data, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

   3.4 We are required by law to: a. Maintain the privacy of your protected health information; b. Give you this Notice of our legal duties and privacy practices; c. Abide by the terms of our Notice currently in effect.

4. Last Revision Date This Notice was last revised on June 16, 2024.

5. How We May Use or Disclose Your Health Information The following examples describe ways we may use or disclose your health information. These are not exhaustive but include:

   5.1 Common Uses and Disclosures a. Treatment: For providing, coordinating, or managing dental care. b. Payment: To obtain payment from insurance or third parties. c. Health Care Operations: For quality assessment, training, legal matters, and audits. d. Appointment Reminders: By postcard, phone, email, text. e. Treatment Alternatives: To inform you of alternatives or benefits. f. Disclosure to Family/Friends: With your consent or when appropriate. g. Disclosure to Business Associates: With contracts ensuring confidentiality.

   5.2 Less Common Uses and Disclosures a. Required by Law b. Public Health Activities c. Victims of Abuse, Neglect, or Domestic Violence d. Health Oversight Activities e. Lawsuits and Legal Actions f. Law Enforcement g. Coroners, Medical Examiners, Funeral Directors h. Organ, Eye, and Tissue Donation i. Research Purposes j. Serious Threat to Health or Safety k. Specialized Government Functions l. Workers’ Compensation

6. Written Authorization for Other Uses Uses or disclosures involving psychotherapy notes, marketing, sale of PHI, or anything not in this Notice require your written consent. You may revoke your authorization in writing at any time.

7. Your Rights Regarding Your Health Information To exercise any of these rights, submit a written request to our Privacy Official.

   7.1 Right to Access and Review
   7.2 Right to Amend
   7.3 Right to Restrict Use and Disclosure
   7.4 Right to Confidential Communications
   7.5 Right to an Accounting of Disclosures
   7.6 Right to a Paper Copy
   7.7 Right to Receive Notification of a Security Breach

8. Special Protections Certain laws provide special protections for HIV, mental health, substance abuse, and genetic information. We follow these as applicable.

9. Changes to This Notice We reserve the right to change this Notice at any time. Revised Notices will be available in our office and on our website.

10. How to File a Complaint You may file a complaint with us or the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate.

11. SMS/Text Messaging Disclosure
    11.1 By providing your phone number, you consent to receive SMS/text messages from our dental office. These messages may include: – Appointment reminders and confirmations – Practice updates or schedule changes – Occasional promotional offers or announcements – Billing or insurance follow-up

    11.2 Message Frequency: Varies based on interaction.

    11.3 Message/Data Rates: May apply per your mobile plan.

    11.4 Opt-Out: Reply “STOP” to opt out.

    11.5 Data Privacy: We do not sell, rent, or share your data without consent.

    11.6 Security: We use protocols to safeguard your data.

    11.7 Your Rights: You may opt out of communications at any time.

12. SMS Privacy Policy
    12.1 When you opt in to receive SMS messages, we collect your phone number and your consent.

    12.2 We use your information to: – Send opted-in messages – Provide updates or promotions based on preferences

    12.3 Sharing: We do not share this information with third parties for marketing.

    12.4 Opt-Out: You may opt out at any time by replying “STOP.”

    12.5 Security: We implement reasonable safeguards against unauthorized access.

    12.6 Contact: info@lakehousedentist.com or 704-887-2744

13. Terms and Conditions (SMS/Text Messaging)
    13.1 Effective Date: March 1, 2025

    13.2 By providing your phone number, you agree to receive messages for: – Appointment reminders – Marketing promotions – General office communications

    13.3 Message Frequency: May vary based on interaction.

    13.4 Message and Data Rates: May apply per your mobile carrier.

    13.5 Privacy: Refer to https://www.lakehousedentist.com/privacy-notice

    13.6 Opt-Out: Reply “STOP” to cancel. Reply “HELP” for support.

    13.7 Liability: We are not responsible for delays or charges from your carrier. You confirm you are the authorized user and at least 18 years old.