NOTICE OF PRIVACY PRACTICES

White Knoll Dentistry 5545 Platt Springs Rd, Lexington, SC 29073
Phone: 803-359-3245

Effective Date: February 16, 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 LEGAL DUTY

We are required by law to maintain the privacy of your medical and dental information, to provide you with this Notice of Privacy Practices, and to follow the terms of this Notice.

We reserve the right to change our privacy practices and this Notice as permitted by law. Any revised Notice will be posted in our office and available upon request.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

• Treatment: We may use or disclose your health information to dentists, hygienists, staff members, physicians, and other health care providers involved in your care.
• Payment & Health Care Operations: We may use or disclose your health information to obtain payment and for operations such as quality assurance, training, licensing, certification, and practice management. If you pay in full out of pocket and request that we not disclose the service to your health plan, we will honor that request as required by law.
• Appointment Reminders: We may contact you with appointment reminders by voicemail, text message, email, postcard, or letter.
• Marketing/Fundraising: We will not use or disclose your health information for marketing or fundraising without your written authorization. We will not sell your health information.
• Legal Requirements: We may disclose your health information when required by law.
• Abuse or Neglect: We may disclose your health information to appropriate authorities if abuse, neglect, or domestic violence is reasonably suspected, as required or permitted by law.
• National Security & Law Enforcement: We may disclose health information to the Armed Forces, authorized federal officials for national security or intelligence activities, or correctional institutions or law enforcement for individuals in custody, when required by law.
• Family, Friends & Others Involved in Care: With your permission, or using professional judgment in an emergency, we may disclose relevant information to a family member, friend, or other person involved in your care or payment for your care.
• Business Associates: We may disclose your health information to business associates (such as billing services, software providers, or accountants) who are required by contract to protect your information.
• Workers’ Compensation: We may disclose your health information for workers’ compensation or similar programs.
• Public Health & Research: We may disclose health information for public health activities or approved research, as permitted by law.

SPECIAL PROTECTIONS FOR SUBSTANCE USE DISORDER INFORMATION (42 CFR PART 2)

Certain health information related to substance use disorder treatment may be protected by federal law under 42 CFR Part 2, in addition to HIPAA.

If this office receives or maintains such information:

• It may be used or disclosed for treatment, payment, and health care operations with your general consent, as permitted by law.
• It will not be used or disclosed to initiate or substantiate legal proceedings against you without your specific written authorization or a court order.
• Recipients of this information may not redisclose it unless permitted by law or authorized by you.

OTHER USES REQUIRING AUTHORIZATION

Any use or disclosure not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time.

BREACH NOTIFICATION

We will notify you if your unsecured protected health information is compromised, as required by law.

YOUR RIGHTS

You have the right to:

• Access and obtain copies of your health information (fees may apply)
• Request restrictions on certain uses or disclosures (we must honor self-pay restrictions)
• Request alternative communications
• Request amendments to your records
• Receive an accounting of certain disclosures

Requests must be made in writing.

QUESTIONS OR COMPLAINTS

If you have questions about this Notice or believe your privacy rights have been violated, contact White Knoll Dentistry at 803-359-3245.

You may also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.