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Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES


SEBRING Oral Surgery

4110 US Hwy 27 N, Suite 103

Sebring, FL  33870


Effective Date: 4/28/2025

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.

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OUR COMMITMENT TO YOUR PRIVACY

We are committed to protecting the privacy of your health information. As part of our treatment, payment, and healthcare operations, we may collect, use, and disclose information about you. This notice outlines our privacy practices and your rights under HIPAA.

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HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

We may use and share your information as we:

  • Treat you (e.g., sharing information with referring dentists or physicians).

  • Run our office (e.g., internal quality assessment, staff training).

  • Bill for our services (e.g., sending info to insurance companies).

  • Contact you (e.g., appointment reminders, treatment options).

  • Comply with the law (e.g., reporting abuse, responding to subpoenas).

  • Prevent serious threats to health or safety.

Other uses and disclosures not listed above require your written authorization.

 

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the right to:

  • Get a copy of your medical record.

  • Request corrections to your medical record.

  • Request confidential communications.

  • Ask us to limit what we use or share.

  • Get a list of those with whom we’ve shared information.

  • Receive a paper copy of this notice.

  • Choose someone to act for you.

  • File a complaint if you believe your rights are violated.

 

OUR RESPONSIBILITIES

We are required to:

  • Maintain the privacy and security of your PHI.

  • Inform you if a breach occurs that may have compromised your information.

  • Provide you with this notice and follow the practices described in it.

  • Not use or share your information other than as described here unless you give us written permission.

 

CHANGES TO THIS NOTICE

We reserve the right to change this notice and will make the new notice available upon request, in our office, and on our website if applicable.

 

CONTACT INFORMATION

If you have any questions or wish to exercise your rights, please contact:

Privacy Officer: Dr. Ross Freeman
Practice Name: SEBRING Oral Surgery
Address: 4110 US Hwy 27 N, Suite 103, Sebring, FL  33870
Phone: 863-658-1662
Email: info@sebringoralsurgery.com

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at https://www.hhs.gov/hipaa.

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