Notice of Privacy Practices
This notice describes how medical and dental information about you may be used and disclosed, and how you can access this information. Please review it carefully.
This notice describes how medical and dental information about you may be used and disclosed, and how you can access this information. Please review it carefully.
You have the following rights regarding the health information we maintain about you:
We may use and disclose your health information for the following purposes:
Most uses and disclosures of your health information for marketing purposes, as well as disclosures that constitute the sale of your health information, require your written authorization. Additionally, psychotherapy notes (if applicable) and certain other sensitive information require specific authorization. You may revoke any authorization in writing at any time, except to the extent we have already relied upon it.
We may disclose your health information without your authorization in the following limited circumstances as permitted or required by law:
We are required by law to:
We employ administrative, technical, and physical safeguards to protect your health information. These include secure electronic health record systems, encrypted communications where feasible, restricted access to patient records, and employee training on privacy and security practices. Our staff is trained to handle all patient information with the utmost confidentiality.
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
To file a complaint with us:
Kathy S. Hevrin DDS
1788 FM157, Ste 101, Mansfield, TX 76063
Phone: (817) 477-4185
To file a complaint with the U.S. Department of Health and Human Services:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W., Washington, D.C. 20201
For more information about this notice or our privacy practices, please contact our office:
Kathy S. Hevrin DDS
1788 FM157, Ste 101
Mansfield, TX 76063
Phone: (817) 477-4185
Email: kathyhevrindds@outlook.com