(727) 531-4462(727) 531-4462Effective 2026-05-01
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.
Baker Family & Cosmetic Dentistry is required by law to maintain the privacy of your protected health information ("PHI") and to provide you with this Notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice while it is in effect.
Treatment: We will use and disclose your PHI to provide, coordinate, or manage your dental care, including consulting with other healthcare providers and referring you for additional services.
Payment: We will use and disclose your PHI to obtain payment for services we provide, including verifying coverage with your insurance and billing your insurance carrier.
Health Care Operations: We will use and disclose your PHI for our day-to-day operations, including quality improvement, training, accreditation, and business management.
Appointment reminders, treatment alternatives, health-related benefits and services, individuals involved in your care, public health and safety, required by law, judicial and administrative proceedings, law enforcement, workers compensation, military and veterans, national security, organ donation, research, decedents.
You have the right to: request restrictions on certain uses and disclosures of your PHI; receive confidential communications by alternative means or at alternative locations; inspect and copy your PHI; amend your PHI; receive an accounting of certain disclosures; obtain a paper copy of this Notice on request.
Other uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. You may revoke that authorization in writing at any time, except to the extent we have already acted in reliance on it.
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. To file with us, contact our Privacy Officer at (727) 531-4462 or write to 231 2nd Street S, Suite 101, Safety Harbor, FL 34695. You will not be retaliated against for filing a complaint.
We reserve the right to change the terms of this Notice and to make new provisions effective for all PHI that we maintain. The current Notice will be posted in our office and on this website.