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.
Effective date: 30 September 2026
Our commitment
Peak Dental Care is required by law to maintain the privacy of your protected health information, to give you this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect. “Protected health information” means information that identifies you and relates to your dental or general health, the care we provide, or payment for that care.
How we may use and disclose your information without your authorization
Treatment
We use your information to provide and coordinate your dental care. For example, we review your chart, radiographs and medical history before treatment; our dentists and hygienists discuss your care with one another; we send impressions, scans or prescriptions to a dental laboratory; and we share relevant information when we refer you to an oral surgeon, orthodontist, periodontist, endodontist or your physician.
Payment
We use your information to bill and collect payment. For example, we send claims to your dental insurance plan containing your diagnosis, the procedures performed and supporting radiographs; we verify coverage and benefits; and we may provide information to a collection agency if an account is not paid.
Health care operations
We use your information to run the practice. For example, for quality review, training of staff and students, licensure and accreditation, business planning, and consulting with our attorneys, accountants and other advisors.
Appointment reminders and follow-up
We may contact you by phone, text message, email or postcard to remind you of an appointment, to tell you a recall visit is due, or to follow up after treatment. If you give us a phone number or email address, we may use it for this purpose. Tell us if you prefer we do not, or if you want us to use a particular number or address.
Treatment alternatives and practice information
We may tell you about treatment options, services and health-related benefits that may interest you.
People involved in your care
We may share information with a family member, guardian, friend or anyone else you identify, to the extent it is relevant to their involvement in your care or payment for it. For a child, we share with a parent or guardian as permitted by Colorado law. If you are unable to agree or object, we will use our professional judgement to decide whether disclosure is in your best interest.
Other uses permitted or required by law
We may use or disclose your information: as required by law; for public health activities, including reporting disease or product safety; to report suspected abuse, neglect or domestic violence; for health oversight activities such as audits and investigations; in response to a court order, subpoena or other lawful process; to law enforcement in the limited circumstances the law allows; to coroners, medical examiners and funeral directors; for organ donation; for research approved by a review board; to avert a serious threat to health or safety; for workers’ compensation claims; and for specialised government functions such as military or national security activities.
Uses that require your written authorization
Other uses and disclosures require your written authorization, including:
- Marketing. Most uses of your information to market a product or service, where we receive payment from a third party.
- Sale of your information. We do not sell protected health information.
- Psychotherapy notes, if any were ever created.
- Photographs. Use of your photographs, including before-and-after images, on our website, social media or in the office.
You may revoke an authorization in writing at any time. We will stop using your information for that purpose, except where we have already acted in reliance on it.
Your rights
- Inspect and copy. You may inspect and obtain a copy of your dental record, including radiographs, normally within 30 days of a written request. We may charge a reasonable, cost-based fee. You may ask for an electronic copy where we hold it electronically.
- Amend. You may ask us in writing to correct information you believe is incorrect or incomplete. We may deny the request, and you may file a statement of disagreement that we will keep with your record.
- Accounting of disclosures. You may request a list of certain disclosures we have made in the six years before your request, other than those for treatment, payment and operations.
- Request restrictions. You may ask us to limit how we use or disclose your information. We are not required to agree, except in one case: if you pay in full, out of pocket, for a service, we must honour a request not to disclose that information to your health plan.
- Confidential communications. You may ask us to contact you in a particular way or at a particular address — for example, only by mail, or only at a specific number. We will accommodate reasonable requests.
- Paper copy. You may ask for a paper copy of this Notice at any time, even if you agreed to receive it electronically.
- Breach notification. We will notify you if a breach compromises the privacy or security of your information.
- Choose someone to act for you. A person with medical power of attorney or legal guardianship may exercise these rights on your behalf.
Our duties
We are required to maintain the privacy of your information, to provide this Notice, to follow the terms currently in effect, and to notify you of a breach. We reserve the right to change this Notice and to make the new terms effective for all information we maintain. If we make a material change, we will post the revised Notice in our office and on our website and make copies available on request.
Complaints
If you believe your privacy rights have been violated, please contact our Privacy Officer. You may also file a written complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, D.C. 20201, by calling 1-877-696-6775, or at hhs.gov/ocr/complaints.
We will not retaliate against you for filing a complaint.
Contact
Privacy Officer
Peak Dental Care
7920 S. University Blvd., Suite 200, Centennial, CO 80122
Phone: 720-489-0797
Email: info@peakdentalcare.com