HIPAA Notice of Privacy Practices

Jivan Dental Aesthetics

Effective Date: 05/15/2026

 

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 Responsibilities

Jivan Dental Aesthetics is required by law to:

  • Maintain the privacy of your health information
  • Provide you with this notice of our legal duties
  • Follow the terms currently in effect
  • Notify you in the event of a breach of unsecured PHI

 

How We May Use and Disclose Your Information

Treatment

We may use and share your information to provide and coordinate your care with other healthcare providers.

Payment

We may use your information to bill and receive payment from insurance companies or other entities.

Healthcare Operations

We may use your information to improve care quality, manage operations, and train staff.

 

Other Permitted Uses

We may disclose information:

  • As required by law
  • For public health and safety
  • For health oversight activities
  • In response to legal proceedings
  • For law enforcement purposes when applicable

 

Uses Requiring Your Authorization

We will not use or disclose your information for:

  • Marketing purposes (beyond permitted communications)
  • Sale of your information

Without your written authorization.

 

Your Rights

You have the right to:

Access Your Records

Request copies of your health records.

Request Corrections

Ask us to correct inaccurate or incomplete information.

Request Restrictions

Ask us to limit what we share (we may not always be able to comply).

Confidential Communications

Request we contact you in a specific way (e.g., only via email or phone).

Accounting of Disclosures

Request a list of disclosures made outside of treatment, payment, and operations.

File a Complaint

If you believe your privacy rights have been violated, you may contact us or file a complaint with the
U.S. Department of Health and Human Services
Office for Civil Rights.

You will not be penalized for filing a complaint.

 

Our Legal Duties

We are required to comply with Health Insurance Portability and Accountability Act and applicable state laws.

 

Changes to This Notice

We reserve the right to update this Notice. Updated versions will be available upon request and on our website.

 

Contact for Privacy Matters

Jivan Dental Aesthetics

Winter Park: 407-628-0200
Mount Dora: 352-383-2959

 

Acknowledgment

By using this website, you acknowledge that you have read, understood, and agreed to these Terms of Service.