NOTICE OF PRIVACY PRACTICES

Soult & Swanson Family Dentistry and Implant Center
Effective Date: February 16, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR MEDICAL INFORMATION IS IMPORTANT TO US.

Contact Information

For more information about our privacy practices, to discuss questions or concerns, or to request additional copies of this notice, please contact our Privacy Officer:

Cori Brown
Phone: 303-337-2794
Address: 1444 S Potomac St #100, Aurora, CO 80014

Our Legal Duty

We are required by law to protect the privacy of your protected health information (“medical information”). We are also required to provide you with this notice explaining our privacy practices, our legal duties, and your rights regarding your medical information.

This notice is effective as of the date listed above and will remain in effect unless replaced. We reserve the right to change our privacy practices and the terms of this notice at any time, as permitted by law. Any changes will apply to all medical information we maintain, including information created or received before the changes were made.

If a material change is made, we will provide you with a revised notice. The current notice will always be available at our facility and on our website, and you may request a copy at any time.

We collect and maintain oral, written, and electronic information to administer our business and provide services to our patients. We maintain physical, electronic, and procedural safeguards to protect your medical information in accordance with state and federal law.

Uses and Disclosures of Your Medical Information

Treatment
We may use or disclose your medical information to dentists, physicians, or other healthcare providers involved in your care for evaluation, diagnosis, and treatment. For example, information may be shared with an oral surgeon to determine if surgical care is needed.

Payment
We may use and disclose your medical information to obtain payment for services provided, including billing your insurance plan or you directly.

Health Care Operations
We may use and disclose your medical information for healthcare operations, including:

• Quality assessment and improvement activities
• Provider evaluation, credentialing, licensing, and training
• Audits, legal services, and fraud prevention
• Business planning, administration, billing, and customer service
• Creating de-identified information or limited data sets

We may also share medical information with other providers or health plans for quality improvement and fraud prevention, as permitted by law.

Your Authorization
You may provide written authorization for us to use or disclose your medical information for purposes not described in this notice. You may revoke your authorization at any time, except where we have already relied on it. We will not use your information for marketing, fundraising, or commercial purposes without your authorization. You may opt out of these communications at any time.

Family, Friends, and Others Involved in Your Care
We may share relevant medical information with individuals involved in your care or payment for care. You will have the opportunity to object unless an emergency or incapacity prevents it.

Health-Related Products and Services
We may contact you about treatment alternatives, health-related benefits, and services.

Appointment Reminders
We may contact you by mail, email, phone, or voicemail to remind you of appointments or treatment. By providing your email address, you consent to receiving reminders and breach notifications electronically unless you request otherwise.

Plan Sponsors
If you are covered under an employer-sponsored dental plan, we may share summary health information with the plan sponsor.

Public Health and Benefit Activities
We may disclose medical information without your permission when required or authorized by law, including for public health reporting, research, legal proceedings, law enforcement, disaster relief, military activities, workers’ compensation, and to prevent serious threats to health or safety.

Special Protections for Substance Use Disorder Records
Substance Use Disorder treatment records receive enhanced protections and generally cannot be disclosed without your consent or a court order.

Business Associates
We may share medical information with business associates who perform services on our behalf. These parties are contractually required to protect your information.

Data Breach Notification
We may use your contact information to notify you of any legally required breach involving your medical information.

Additional Restrictions
Certain information is subject to additional protections under federal and state law, including:

• HIV/AIDS
• Mental health information
• Genetic testing information
• Alcohol and drug abuse records
• Sexually transmitted diseases and reproductive health information
• Child or adult abuse or neglect

Your Rights

You have the right to:

1. Inspect and obtain a copy of your health records
2. Request an amendment to your health information
3. Receive an accounting of certain disclosures
4. Receive a copy of this Notice of Privacy Practices
5. Decide whether to authorize certain uses or disclosures, including marketing
6. Request confidential communications
7. Restrict certain disclosures of your information
8. Submit written requests for amendments (approval not guaranteed, but reviewed)
9. File a complaint if you believe your rights have been violated
10. Opt out of fundraising communications

Complaints

If you believe your privacy rights have been violated or you disagree with a decision regarding your medical information, you may file a complaint with our Privacy Officer verbally or in writing.

You may also file a complaint with the U.S. Department of Health and Human Services:

Office for Civil Rights
200 Independence Avenue, SW, Room 509F
Washington, DC 20201
Phone: 1-800-368-1019

We will not retaliate against you for filing a complaint.