Notice of Privacy Practices

Family Holistic Dentistry

Effective Date: February 16, 2026

Our Commitment to Your Privacy

At Family Holistic Dentistry, we are committed to protecting the privacy and security of your health information. This Notice of Privacy Practices explains how we may use and disclose your protected health information (PHI), your rights regarding that information, and our legal duties to safeguard it.

We believe that trust, transparency, and respect are essential parts of holistic care. Protecting your personal information is part of how we care for the whole person — body, mind, and spirit.

How We May Use and Disclose Your Health Information

We may use and disclose your health information for the following purposes:

Treatment

We may use and share your health information to provide, coordinate, or manage your dental care. This may include sharing information with other healthcare providers involved in your care.

Payment

We may use and disclose your health information to bill and collect payment for services provided to you. This may include disclosures to insurance companies or other third-party payers.

Healthcare Operations

We may use and disclose your information for practice operations such as quality assessment, staff training, licensing, and business management.

As Required by Law

We may disclose your health information when required to do so by federal, state, or local law.

Public Health and Safety

We may disclose information for public health activities, reporting abuse or neglect, preventing serious threats to health or safety, or complying with health oversight activities.

Business Associates

We may share your information with business associates who perform services on our behalf, such as billing services or electronic health record providers. These associates are required by law to protect your information.

Special Protections for Substance Use Disorder Records

Certain health information related to substance use disorder (SUD) diagnosis, treatment, or referral may be subject to additional federal protections under 42 CFR Part 2.

When applicable, such information may be used or disclosed for treatment, payment, and healthcare operations as permitted by law. Family Holistic Dentistry will not use or disclose SUD-related records in a manner prohibited by federal regulations and will apply additional safeguards when required.

Disclosures of SUD-related information may not be re-disclosed by the recipient unless permitted by law.

Your Rights Regarding Your Health Information

You have the right to:

• Request restrictions on certain uses or disclosures of your health information

• Request confidential communications, such as being contacted at a specific phone number or address

• Inspect and obtain copies of your health records

• Request corrections to your health information if you believe it is incorrect or incomplete

• Receive an accounting of disclosures of your health information

• Obtain a paper copy of this Notice of Privacy Practices at any time

To exercise any of these rights, please contact our office using the information below.

Our Responsibilities

We are required by law to:

• Maintain the privacy and security of your protected health information

• Provide you with this Notice of Privacy Practices

• Follow the terms of this notice

• Notify you in the event of a breach of unsecured protected health information

We reserve the right to change this Notice and make the revised notice effective for information we already have as well as information we receive in the future. The most current version will be available in our office and on our website.

Questions or Complaints

If you have questions about this Notice or believe your privacy rights have been violated, you may contact:

Privacy Officer
Megan Rippy
Family Holistic Dentistry
Phone: 303-219-0499
Email: office@carmenburke.com

You may also file a complaint with the U.S. Department of Health and Human Services. You will not be penalized or retaliated against for filing a complaint.

A Final Word

At Family Holistic Dentistry, your health, dignity, and trust matter deeply to us. We are honored to care for you and are committed to protecting your personal information with the same intention and respect that we bring to every aspect of your care.