Notice of Privacy Practices

Effective Date: November 3, 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.

This Notice of Privacy Practices (“Notice”) describes how Today’s Modern Dentistry may use and disclose your Protected Health Information (“PHI”) in accordance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and other applicable federal and state privacy laws.

This Notice also explains your rights regarding your health information and our responsibilities for protecting your privacy.

This Notice applies to the dental care and related healthcare services provided by Today’s Modern Dentistry at our Sarasota and Venice, Florida locations.

1. Our Commitment to Your Privacy

At Today’s Modern Dentistry, protecting your personal and dental health information is an important part of providing quality patient care.

We are required by law to:

• Maintain the privacy and security of your Protected Health Information.
• Provide you with information about our legal duties and privacy practices.
• Follow the terms of the Notice currently in effect.
• Notify affected individuals when required by law if a breach of unsecured PHI occurs.
• Respect your rights concerning your medical and dental information.

Protected Health Information includes information that identifies you and relates to your past, present, or future physical or oral health condition, the healthcare services you receive, or payment for those services.

2. How We May Use and Disclose Your Protected Health Information

We may use or disclose your PHI for treatment, payment, healthcare operations, and other purposes permitted or required by law.

A. For Treatment

We may use and disclose your PHI to provide, coordinate, and manage your dental care.

For example, we may share relevant dental records, X-rays, treatment plans, or other information with dental specialists, laboratories, referring providers, or other healthcare professionals involved in your treatment.

This helps ensure that you receive appropriate and coordinated dental care.

B. For Payment

We may use and disclose your PHI to obtain payment for dental services provided to you.

Examples include:

• Submitting claims to dental insurance providers.
• Verifying insurance eligibility and benefits.
• Processing payments and billing statements.
• Obtaining authorization for certain dental procedures.
• Coordinating payment with authorized billing service providers.

C. For Healthcare Operations

We may use and disclose your PHI for activities necessary to operate Today’s Modern Dentistry and maintain the quality of our services.

These activities may include:

• Quality assessment and improvement.
• Staff training and professional development.
• Licensing and accreditation activities.
• Internal audits and compliance reviews.
• Administrative and business management activities.
• Evaluating and improving patient care.

D. Appointment Reminders and Health-Related Communications

We may contact you to provide appointment reminders, scheduling information, follow-up instructions, treatment recommendations, and other healthcare-related communications.

Depending on your communication preferences and applicable requirements, we may contact you by telephone, text message, email, or postal mail.

We take reasonable precautions to protect your privacy when communicating with you.

E. Treatment Alternatives and Health-Related Services

We may use your health information to inform you about treatment alternatives, preventive dental care, and health-related services that may be relevant to your oral health needs.

Certain marketing communications may require your written authorization under HIPAA.

F. Disclosures Required or Permitted by Law

We may use or disclose your PHI without your written authorization when required or permitted by applicable law, including:

• Public health activities and legally required reporting.
• Reporting suspected abuse, neglect, or domestic violence when authorized or required by law.
• Health oversight activities, including audits and investigations.
• Judicial or administrative proceedings under applicable legal requirements.
• Certain law enforcement purposes.
• Preventing or reducing a serious and imminent threat to health or safety.
• Workers’ compensation matters as authorized by law.
• Disclosures to coroners, medical examiners, or funeral directors when permitted by law.
• Other disclosures specifically permitted or required under HIPAA.

G. Family Members and Individuals Involved in Your Care

We may share relevant information with family members, caregivers, or other individuals involved in your care or payment for your care, when permitted by law.

Whenever appropriate, we will give you an opportunity to agree or object to such disclosures.

H. Business Associates

We may share PHI with third-party service providers who perform services on our behalf, such as billing, technology support, practice management, or secure data storage.

When required by HIPAA, these providers must enter into appropriate Business Associate Agreements and protect the confidentiality and security of your information.

I. Uses and Disclosures Requiring Written Authorization

Certain uses and disclosures of PHI require your written authorization, including most uses or disclosures for marketing purposes, the sale of PHI, and most uses or disclosures of psychotherapy notes, if applicable.

Other uses and disclosures not described in this Notice will be made only with your written authorization unless otherwise permitted or required by law.

You may revoke your authorization in writing at any time, except to the extent that we have already acted in reliance on it.

3. Your Rights Regarding Your Protected Health Information

Under HIPAA, you have important rights concerning your medical and dental information.

A. Right to Access Your Records

You have the right to inspect and obtain a copy of your PHI maintained in a designated record set, including dental records, treatment information, and billing records, subject to limited exceptions.

You may request an electronic copy when the information is maintained electronically and the requested format is readily producible.

We may charge a reasonable, cost-based fee as permitted by law.

B. Right to Request an Amendment

If you believe that information in your dental record is incorrect or incomplete, you may request an amendment.

We may deny your request in certain circumstances permitted by law. If your request is denied, we will provide a written explanation of the decision and information about your rights.

C. Right to an Accounting of Disclosures

You may request an accounting of certain disclosures of your PHI made during the six years preceding your request.

Some disclosures, including many made for treatment, payment, and healthcare operations, are generally excluded from this accounting, subject to applicable law.

D. Right to Request Restrictions

You may request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations.

We are generally not required to agree to every requested restriction.

However, when you pay out of pocket in full for a specific healthcare service or item and request that we not disclose related information to your health plan for payment or healthcare operations, we must honor that request unless disclosure is required by law.

E. Right to Request Confidential Communications

You have the right to request that we communicate with you about your health information through a specific method or at a particular location.

For example, you may request that we contact you only at a designated telephone number or send correspondence to a specific mailing address.

We will accommodate reasonable requests.

F. Right to a Paper Copy

You have the right to receive a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

G. Right to Receive Breach Notifications

You have the right to be notified of a breach involving your unsecured PHI when notification is required by applicable law.

H. Right to Choose Someone to Act on Your Behalf

If you have given someone medical power of attorney or if someone is your legal guardian or authorized personal representative, that person may exercise certain rights and make decisions about your health information on your behalf, subject to applicable law.

We may verify that the individual has appropriate authority before taking action.

To exercise any of these rights, please contact our office using the information provided below.

4. Our Responsibilities

Today’s Modern Dentistry is committed to maintaining the confidentiality, integrity, and security of patient information.

We are responsible for:

• Protecting PHI in accordance with applicable privacy and security requirements.
• Limiting uses and disclosures to those authorized or permitted by law.
• Applying the minimum necessary standard when required.
• Maintaining appropriate administrative, physical, and technical safeguards.
• Providing patients with access to their information as required by law.
• Responding to privacy-related requests and complaints.
• Notifying individuals of breaches when legally required.

We will not use or disclose your PHI in ways that are inconsistent with this Notice unless you provide written authorization or applicable law otherwise permits or requires the disclosure.

5. Changes to This Notice

Today’s Modern Dentistry reserves the right to update or revise this Notice of Privacy Practices.

Any revised Notice may apply to PHI that we already maintain, as well as information we receive in the future.

The current version will be made available at our offices and on our website.

We encourage patients to review this Notice periodically to stay informed about our privacy practices.

6. Questions and Complaints

If you have questions about this Notice or believe your privacy rights have been violated, you may submit a complaint directly to Today’s Modern Dentistry.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.

U.S. Department of Health and Human Services

Office for Civil Rights

Website: https://www.hhs.gov/hipaa/filing-a-complaint/

We will not retaliate against you for filing a complaint or exercising your privacy rights.

For questions, requests, or complaints related to our privacy practices, please contact our designated Privacy Officer through either office.

Today’s Modern Dentistry – Sarasota Office

7208 Beneva Road S.
Sarasota, FL 34237

Phone: (941) 326-2396

Today’s Modern Dentistry – Venice Office

1956 S Tamiami Trl, Suite B
Venice, FL 34239

Phone: (941) 239-1981

Website: https://www.todaysmoderndentistry.com/

7. Acknowledgment of Receipt

Patients may be asked to acknowledge receipt of this Notice of Privacy Practices during their initial visit.

This acknowledgment confirms that the Notice was provided or made available to the patient. It does not mean that the patient agrees to every use or disclosure described in the Notice.

If a patient declines to sign the acknowledgment, we will document our good-faith effort to obtain it, as required by applicable HIPAA regulations.

A patient’s refusal to sign the acknowledgment does not prevent them from receiving dental care.

---

Today’s Modern Dentistry

Sarasota & Venice, Florida

Effective Date: November 3, 2026

We are committed to protecting your privacy while providing high-quality dental care.