HIPAA Notice of Privacy Practices
Last Updated: December 2025
This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
Our Commitment to Your Privacy
Mapleton Family Dentistry is committed to protecting the privacy of your protected health information (PHI) as required by the Health Insurance Portability and Accountability Act (HIPAA).
How We May Use and Disclose Your Health Information
We may use and disclose your health information for the following purposes:
Treatment
To provide, coordinate, or manage your dental care.
Payment
To bill and collect payment from insurance providers or other responsible parties.
Healthcare Operations
For practice operations such as quality assessment, staff training, and administrative activities.
Other Permitted Uses
We may also use or disclose your information:
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As required by law
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For public health activities
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To prevent serious threats to health or safety
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For law enforcement purposes, when legally required
Your Rights Under HIPAA
You have the right to:
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Request access to your medical records
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Request corrections to your health information
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Request restrictions on certain uses or disclosures
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Request confidential communications
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Receive a paper or electronic copy of this notice
Requests must be submitted in writing.
Our Responsibilities
We are required by law to:
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Maintain the privacy and security of your PHI
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Notify you if a breach of unsecured PHI occurs
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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:
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Mapleton Family Dentistry
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The U.S. Department of Health and Human Services
You will not be retaliated against for filing a complaint.
Contact Information
For questions, concerns, or requests regarding this Notice, contact:
Mapleton Family Dentistry
108 N 1600 W
Mapleton, UT 84664