Effective date: August 28, 2026
THIS NOTICE DESCRIBES HOW YOUR PROTECTED HEALTH INFORMATION MAY BE USED AND DISCLOSED, AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice applies to protected health information (PHI) held by Norwalk Dental Group as a patient of record — it is separate from our website Privacy Policy, which covers information collected through this website only.
Your Rights
When it comes to your health information, you have certain rights, and we have certain responsibilities to help you exercise them.
Get a Copy of Your Dental Record
You can ask to see or get a paper or electronic copy of your dental record and other health information we have about you. We will provide a copy, usually within 30 days of your request, and may charge a reasonable, cost-based fee. You may also request to inspect your record in person at our office.
Ask Us to Correct Your Record
You can ask us to correct health information you believe is incorrect or incomplete. If we decline, we'll explain why in writing within 60 days.
Request Confidential Communications
You can ask us to contact you in a specific way (for example, a particular phone number or address). We will accommodate all reasonable requests.
Ask Us to Limit What We Share
You can ask us not to use or share certain health information for treatment, payment, or operations. We are not required to agree, and may decline if it would affect your care. If you pay out-of-pocket in full for a service, you can ask us not to share information about that service with your insurer, and we will honor that request unless the law requires otherwise.
Get a Paper Copy of This Notice
You can request a paper copy of this notice at any time, even if you've agreed to receive it electronically.
Choose Someone to Act for You
If someone has your medical power of attorney or is your legal guardian, that person can exercise your rights and make choices about your health information on your behalf, once we've verified their authority.
File a Complaint
If you believe your privacy rights have been violated, you can file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services Office for Civil Rights by mail (200 Independence Avenue, S.W., Washington, D.C. 20201), phone (1-877-696-6775), or online at hhs.gov. We will not retaliate against you for filing a complaint.
Your Choices
For certain situations, you can tell us your preference for how we share your information:
- Sharing information with family, friends, or others involved in your care
- Sharing information in a disaster relief situation
If you're unable to tell us your preference (for example, in an emergency), we may share information if we believe it's in your best interest.
We will never share your information for marketing purposes, in exchange for payment, or for fundraising without your written permission.
How We May Use and Share Your Information
We typically use and share your health information to:
Treat You
We may share your information with other healthcare professionals involved in your treatment.
Run Our Practice
We use your information to manage your care and contact you when necessary — for example, appointment reminders or treatment follow-ups.
Bill for Services
We share information with your dental insurance plan so it can process and pay for your care.
Other Permitted or Required Uses
In limited circumstances defined by law, we may also share information to help with public health and safety issues, for health research, to comply with the law, in response to organ donation requests, with a medical examiner or funeral director when necessary, for workers' compensation or law enforcement purposes, or in response to a court order or subpoena.
Our Responsibilities
- We are required by law to protect the privacy and security of your health information.
- We will notify you promptly if a breach may have compromised your information.
- We must follow the practices described in this notice.
- We will not use or share your information beyond what's described here without your written permission, which you may revoke at any time.
Changes to This Notice
We may update this notice from time to time, and any changes will apply to all health information we hold. The current notice will always be available at our office and on this website.
Contact Information
For questions about this notice, to exercise any of your rights, or to file a complaint, contact us at info@norwalkdentalgroup.com or 9A Washington St, Norwalk, CT 06854.