Effective Date: April 16th, 2026

Location: 10750 W McDowell Rd, Suite B200, Avondale, AZ

Phone: 623-388-5888

Desert Lake Family Dentistry is committed to protecting your personal health information (PHI). Your privacy matters to us, and we follow all applicable federal regulations under the Health Insurance Portability and Accountability Act (HIPAA) and Arizona state requirements for patient confidentiality.

Our Legal Duty

We are required by federal law (HIPAA) to protect the privacy of your protected health information (PHI), provide this Notice explaining our privacy practices, and notify you if a breach occurs that compromises your information. We must follow the terms of this Notice.

How We May Use and Disclose Your Health Information

1. Treatment

We may use or share your PHI to provide, coordinate, or manage your dental care.

Examples include:

Diagnosing and treating your dental conditions
Consulting with a specialist or dental laboratory
Sharing information with other providers involved in your care

2. Payment

We may use or disclose PHI to obtain payment for services, including:

Submitting claims to your insurance
Determining eligibility or coverage
Responding to insurer requests

Your insurer may request information such as treatment notes, radiographs, or clinical findings.

3. Health Care Operations

We may use PHI for operational purposes, such as:

Quality assessment and improvement
Credentialing and staff training
Licensing, audits, and compliance activities

These activities help us maintain high-quality care.

Other Uses and Disclosures Allowed by Law

We may disclose your PHI without written authorization when required or permitted by law. Examples include:

Public health reporting
Reporting abuse or neglect
Health oversight audits and investigations
Workers’ compensation claims
Law enforcement requests
Court orders or administrative proceedings
Coroner or medical examiner functions
Preventing or reducing a serious threat to health or safety

Uses and Disclosures Requiring Your Authorization

We must obtain your written authorization for:

Marketing communications not related to your treatment
Sale of health information
Most uses of psychotherapy notes
Any use or disclosure not described in this Notice

You may revoke authorization at any time in writing.

Your Rights Related to Your Health Information

1. Right to Access

You may request to inspect or obtain a copy of your PHI, including digital or electronic copies. A reasonable fee may apply.

2. Right to Request Restrictions

You may request limits on how we use or disclose your information.

We are not required to agree except when:

You pay for a service entirely out of pocket
You request that information not be shared with your insurer

3. Right to Confidential Communications

You may request that we contact you at:

A different mailing address
A specific phone number
By alternative communication methods

We will accommodate reasonable requests.

4. Right to Amend Records

If you believe your information is incorrect or incomplete, you may request an amendment.

We may deny requests in certain circumstances, but you will be notified in writing.

5. Right to an Accounting of Disclosures

You may request a list of certain disclosures made within the last six years, excluding those made for treatment, payment, or operations.

6. Right to a Paper or Digital Copy of This Notice

You can request a copy at any time.

State‑Specific Information: Arizona

Based on required search results, there are no additional Avondale‑specific privacy rules beyond standard HIPAA.

Arizona does require extra confidentiality for certain sensitive health information, including:

HIV/AIDS status
Mental health records
Drug/alcohol treatment information

We handle these categories with heightened protection and do not disclose them unless legally authorized.

Changes to This Notice

We reserve the right to revise this Notice at any time. A current version will always be available:

In our office
Via printed copy upon request

Questions or Complaints

If you believe your rights have been violated or have questions about this Notice, you may contact us:

Desert Lake Family Dentistry

Privacy Officer

10750 W McDowell Rd, Suite B200

Avondale, AZ