top of page

Privacy Policy

Wells Family Dentistry Notice of Privacy Practices



Introduction: This document outlines how your medical information may be utilized and disclosed by Wells Family Dentistry ("the Practice"). It also guides you on how to access this information. We urge you to review this notice thoroughly.

I. Practice Overview This Notice applies to the privacy practices of Wells Family Dentistry. In this document, "we" and "our" refer to the Practice, while "you" and "your" refer to our patients.


II. Contact Information For inquiries or more details about this Notice, please reach out to the Wells Family Dentistry Privacy Official at:

III. Commitment to Privacy Your health information's privacy is crucial to us. We are dedicated to safeguarding your personal health information. This Notice explains our practices regarding the use and disclosure of your protected health information for treatment, payment, and healthcare operations, in addition to other uses permitted or required by law.

Legal Obligations:

  • Ensure the privacy of your protected health information.

  • Provide this Notice outlining our duties and privacy practices regarding your information.

  • Comply with the current version of this Notice.


IV. Revision Date The latest revision of this Notice was on January 1, 2024.


V. Usage and Disclosure of Health Information We may use or disclose your health information for the following purposes:


A. Routine Uses and Disclosures:

  1. Treatment: For dental treatments or services, including sharing information with other healthcare providers involved in your care.

  2. Payment: To process payments with your health plans and insurers.

  3. Healthcare Operations: For operational purposes, such as treatment reviews, staff evaluations, and business management.


B. Other Uses and Disclosures: Including but not limited to public health activities, legal requirements, law enforcement purposes, and research. These activities are governed by law and sometimes require your authorization.

VI. Your Authorization Certain uses or disclosures not covered by this Notice or the laws that apply to us will only be made with your written authorization. You may revoke this authorization at any time, except where action has already been taken based on it.

VII. Your Rights You have rights regarding your health information, such as accessing, amending, and requesting restrictions on our use and disclosure of your information. Requests must be submitted in writing to our Privacy Official.

VIII. Special Protections Special privacy protections apply to HIV-related, alcohol and substance abuse, mental health, and genetic information. These protections may restrict use and disclosure beyond what is described in this Notice.

IX. Changes to This Notice We reserve the right to amend this Notice. Changes will apply to information we already hold, as well as new information. The revised Notice will be available in our office and, if applicable, on our website.

X. Complaints Should you have any complaints regarding your privacy rights or our information practices, you can contact our Privacy Official or file a complaint with the U.S. Department of Health and Human Services. We assure you that we will not retaliate against you for filing a complaint.

Contact Information: For any questions or complaints, please contact our Privacy Official at the email provided above.


Effective Date of This Notice: January 1, 2024

bottom of page