Effective Date: April, 16th, 2026
This Notice describes how your health information may be used and disclosed and how you can access this information. Please review it carefully.
Atrium Dental is committed to protecting your privacy. We are required by federal law (HIPAA) and applicable Arizona laws to maintain the security and confidentiality of your Protected Health Information (PHI), provide you with this Notice of our legal duties and privacy practices, and notify you if a breach occurs that compromises the privacy or security of your unsecured PHI.
We must follow the terms of this Notice for as long as it remains in effect. We may update or revise this Notice at any time as permitted by law. If changes occur, we will make the revised Notice available at our office and provide copies upon request.
How We May Use and Disclose Your Health Information
We may use or disclose your PHI for the following purposes:
- Treatment
We may use and disclose your PHI to provide, coordinate, or manage your dental care. This includes sharing information with specialists, labs, pharmacies, or other healthcare providers treating you.
- Payment
Your PHI may be used to obtain payment for services, including billing, claims management, collections, and insurance eligibility verification.
- Healthcare Operations
We may use your information for practice operations such as:
- Quality assessment
- Credentialing and training
- Licensing and compliance activities
- Internal administration and management
Other Uses and Disclosures Permitted or Required by Law
Individuals Involved in Your Care
We may disclose information to family members, caregivers, or others involved in your care as allowed by law or as you permit.
Disaster Relief
Information may be shared to assist emergency or disaster relief organizations.
Public Health and Safety
We may disclose PHI for reasons including:
- Preventing or controlling disease
- Reporting abuse or neglect
- Reporting adverse drug reactions
- Product recalls
- Exposure notifications
Law Enforcement
We may disclose PHI when required for law enforcement purposes in compliance with HIPAA and Arizona law.
Health Oversight
PHI may be shared with agencies conducting audits, inspections, or investigations.
Judicial or Administrative Proceedings
Information may be disclosed in response to subpoenas, court orders, or administrative requests as permitted by law.
Research
Limited PHI may be disclosed for approved research projects with appropriate privacy safeguards.
Coroners, Medical Examiners, Funeral Directors
We may disclose PHI necessary for these professionals to perform their duties.
National Security & Military
If you are a member of the U.S. Armed Forces or involved in national security functions, your PHI may be disclosed as required.
Fundraising
We may contact you to support practice‑related fundraising. You may opt out at any time.
Uses Requiring Written Authorization
Certain uses of PHI require your written authorization, including:
- Psychotherapy notes (if applicable)
- Marketing not related to your care
- Sale of PHI
You may revoke authorization at any time.
Your Rights Regarding Your Health Information
- Right to Access
You may request to view or obtain copies of your PHI. Electronic copies are available when feasible. Reasonable, cost‑based fees may apply.
- Right to Request Restrictions
You may request limitations on how your PHI is used or disclosed. We are not required to agree, except when you request a restriction related to out‑of‑pocket payments made in full.
- Right to Request Confidential Communications
You may request alternate contact methods or locations.
- Right to Amend
If you believe your information is incorrect or incomplete, you may request an amendment. We may deny requests in certain circumstances and will provide written explanation.
- Accounting of Disclosures
You may request a list of PHI disclosures made for purposes other than treatment, payment, healthcare operations, and certain other exemptions.
- Notification of Breach
You will be notified in writing if a breach occurs that compromises the privacy or security of your PHI.
- Right to Paper Copy
You may request a paper copy of this Notice at any time.
State‑Specific Information: Arizona
Arizona law generally aligns with HIPAA and does not impose additional requirements for dental records except in special categories (HIV status, genetic information, and certain mental health records). If Atrium Dental holds such records, we will comply with all applicable Arizona statutes requiring stricter confidentiality.
Questions, Requests, or Complaints
If you have questions, want to exercise any privacy rights, or wish to file a complaint:
Atrium Dental – Privacy Officer
4425 E. Agave Rd. #130, Phoenix, AZ 85044
Phone: (480) 940‑4321
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
