Our dentist, Dr. R. Erik Cantwell, and our dental team in West Jordan, Utah, are HIPPA compliant. The health record we maintain and billing records are the physical property of the practice. The information in it, however, belongs to you. You have a right to:
• Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office. We are not required to grant the request but we will comply with any request granted.
• Obtain a paper copy of this Notice of Privacy Practices for Protected Health Information (“Notice”) by making a request at our office.
• Request that you be allowed to inspect and copy your health record and billing record—you may exercise this right by delivering the request in writing to our office.
• Appeal a denial of access to your protected health information except in certain circumstances.
• Request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our office.
• File a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information.
• Obtain an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to our office. An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course of providing care.
• Request that communication of your health information be made by alternative means or at an alternative location by delivering the request in writing at our office.
• Revoke authorizations that you made previously to use or disclose information except to the extent information or action has already been taken by delivering a written revocation to our office.
If you want to exercise any of the above rights, please contact Copper Ridge Dental, in person or in writing, during normal hours. We will provide you with assistance on the steps to take to exercise your rights.
