Camarillo Springs Dental Care, Oral Surgery & Implant Center
Effective Date: January 1, 2020 Last Updated: February 1, 2026
This Notice describes how medical and dental information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our Commitment to Your Privacy
Camarillo Springs Dental Care, Oral Surgery & Implant Center is committed to protecting the privacy of your health information. We are required by law to:
- Maintain the privacy of your Protected Health Information (PHI)
- Provide you with this Notice of our legal duties and privacy practices
- Follow the terms of this Notice currently in effect
“Protected Health Information” (PHI) means information that identifies you and relates to your past, present, or future physical or mental health condition, the care you receive, or payment for that care.
How We May Use and Disclose Your Health Information
We may use and disclose your health information without your authorization for the following purposes:
1. Treatment
We may use and share your information to provide, coordinate, or manage your dental care. For example, we may share information with specialists, labs, or other healthcare providers involved in your care.
2. Payment
We may use and disclose your information to bill and collect payment from you, your insurance company, or a third party.
3. Healthcare Operations
We may use and disclose your information for practice operations such as quality improvement, training, licensing, audits, and business management.
4. Legal and Public Health Purposes
We may disclose your information when required by law, such as for public health activities, health oversight, judicial proceedings, law enforcement, or to prevent a serious threat to health or safety.
5. Special Protections for Substance Use Disorder (SUD) Records
Some health information related to substance use disorder (SUD) treatment may be protected by federal law (42 CFR Part 2) and California law.
- These records receive extra privacy protections.
- In most cases, we cannot disclose SUD-related records without your specific written authorization, even for purposes that are otherwise allowed under HIPAA.
- When permitted by law, SUD-related information may be used or disclosed for:
- Treatment
- Payment
- Healthcare operations
- Public health and safety purposes
- As otherwise allowed or required by law
Important: Any disclosure of SUD-related information is subject to stricter legal limits, and recipients may be prohibited from redisclosing that information without your permission or as allowed by law.
Other Uses and Disclosures
We may also contact you for:
- Appointment reminders
- Treatment alternatives
- Health-related benefits or services
We will not use or share your information for marketing or sell your information without your written authorization.
Any other use or disclosure not described in this Notice will be made only with your written permission. You may revoke your authorization at any time in writing.
Your Rights Regarding Your Health Information
You have the right to:
- Get a copy of your health records
- Request corrections to your records
- Request restrictions on certain uses or disclosures
- Request confidential communications
- Get a list of certain disclosures we have made
- Get a paper copy of this Notice at any time
- Choose someone to act for you
- File a complaint if you believe your privacy rights have been violated
Our Responsibilities
We are required by law to:
- Maintain the privacy and security of your PHI
- Notify you promptly if a breach occurs that may have compromised your information
- Follow the duties and privacy practices described in this Notice
Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Camarillo Springs Dental Care, Oral Surgery & Implant
816 Camarillo Springs Rd, Suite L, Camarillo, CA 93012
805.388.3008
You may also file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
www.hhs.gov/ocr/privacy/hipaa/...
You will not be retaliated against for filing a complaint.
Changes to This Notice
We reserve the right to change this Notice at any time. The revised Notice will apply to all PHI we maintain. The current version will be available:
· On our website
· In our office
· Upon request
This notice may be updated periodically. Please check back for the most current version.
