Terms & Conditions

**Your Information. Your Rights. Our Responsibilities**

**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**

**Your Rights**

• Get an electronic or paper copy of your medical record.
• Ask us to correct your medical record.
• Request confidential communication.
• Ask us to limit the information we share.
• Get a list of those with whom we’ve shared your information.
• Get a copy of this privacy notice.
• Choose someone to act for you.
• File a complaint if you believe your privacy rights have been violated.

**Your Choices**

• Share information with your family, close friends, or others involved in your care.
• Share information in a disaster relief situation.
• Include your information in a hospital directory.
• Opt out of participating in an HIE.
• Choose not to be contacted for fundraising efforts.

**Our Use and Disclosures**

• Treat you.
• Run our organization.
• Bill for your services.
• Appointment reminders.
• Health Information Exchanges (HIEs).
• De-identified and aggregated data.
• Business associates.
• Help with public health and safety issues.
• Do research.
• Comply with the law.
• Respond to organ and tissue donation requests.
• Work with a medical examiner or funeral director.
• Address workers’ compensation, law enforcement, and other government requests.
• Respond to lawsuits and legal actions.

**Notice Regarding Technology**

We may use electronic software, services, and equipment to share your protected health information (“PHI”) with you or third parties. In any event, certain unencrypted storage, forwarding, communications, and transfers may not be confidential. We will take measures to safeguard the data transmitted.

**Our Responsibilities**

We are required by law to maintain the privacy and security of your PHI. We will not use or disclose your PHI for marketing purposes or to sell your PHI unless you have agreed to this use or disclosure.

**Changes to the Terms of this Notice**

From time to time, we may change this privacy statement, applicable to all PHI we maintain about you. The new notice will be available on our website.

**Contact Us**

If you have any questions about this privacy policy, concerns about the way Smile Wellness processes your information, or require assistance in managing your privacy choices, please get in touch with us at: