NOTICE OF PRIVACY PRACTICES

Effective Date: August 13, 2026

Avion Dental
4665 Chino Hills Pkwy, Suite D
Chino Hills, CA 91709
(909) 597-3445
AvionDental.com

YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.

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.

Avion Dental is committed to protecting the privacy and security of your protected health information (“PHI”).

This Notice of Privacy Practices describes how we may use and disclose your dental and health information, explains your rights regarding that information, and describes our responsibilities under the Health Insurance Portability and Accountability Act (“HIPAA”) and other applicable laws.

YOUR RIGHTS

When it comes to your health information, you have certain rights.

Get an Electronic or Paper Copy of Your Dental Record

You may ask to see or receive an electronic or paper copy of your dental record and other health information we maintain about you.

We will provide a copy or summary of your health information as required by applicable law.

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

Contact our office to request access to your records.

Ask Us to Correct Your Dental Record

If you believe health or dental information in your record is incorrect or incomplete, you may ask us to correct it.

We may deny your request in certain circumstances. If we deny your request, we will explain the reason in writing as required by law.

Request Confidential Communications

You may ask us to communicate with you in a particular way or at a particular location.

For example, you may ask us to:

Call your mobile phone instead of your home telephone
Contact you only at work
Send correspondence to an alternative mailing address
Use another reasonable method of communication

We will accommodate reasonable requests.

Ask Us to Limit What We Use or Share

You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations.

We are generally not required to agree to every request.

However, if you pay for a healthcare service or item completely out of pocket, you may ask us not to disclose information about that service to your health insurer for payment or healthcare operations purposes.

We will honor such a request when required by law unless another law requires us to disclose the information.

Get a List of Certain Disclosures

You may request an accounting of certain disclosures of your health information.

This is a list showing certain instances in which we disclosed your health information, who received it, and why it was disclosed.

Certain disclosures, including many disclosures made for treatment, payment, or healthcare operations, may not be included.

We will provide an accounting in accordance with applicable law.

Get a Copy of This Notice

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

A current copy is also available through Avion Dental’s website.

Choose Someone to Act for You

If you have given another individual healthcare power of attorney or that individual is your legal guardian or authorized personal representative, that person may exercise certain rights and make choices regarding your health information on your behalf.

We may verify that the individual has legal authority to act for you before taking action.

File a Complaint

If you believe your privacy rights have been violated, you may submit a complaint directly to Avion Dental.

You may also file a complaint with the:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201

Phone: 1-877-696-6775

You may also submit a complaint through the U.S. Department of Health and Human Services Office for Civil Rights.

Avion Dental will not retaliate against you for filing a complaint.

YOUR CHOICES

For certain health information, you may tell us how you would like your information shared.

Family Members and Others Involved in Your Care

You may tell us whether we may share relevant health information with:

Family members
Close friends
Caregivers
Other individuals involved in your care
Individuals involved in payment for your care

If you are unable to communicate your preference, such as during an emergency, we may use professional judgment to disclose information when we believe doing so is in your best interest and is permitted by law.

Disaster Relief

We may disclose appropriate health information to organizations assisting with disaster relief when permitted by law.

Marketing

For certain marketing activities involving your protected health information, we will obtain your written authorization when HIPAA requires it.

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

General communications about Avion Dental services that do not constitute HIPAA-regulated marketing may be handled differently as permitted by law.

Sale of Health Information

Avion Dental will not sell your protected health information when HIPAA requires your authorization for such a transaction without first obtaining the required written authorization.

HOW WE TYPICALLY USE OR SHARE YOUR HEALTH INFORMATION

HIPAA allows us to use and disclose your health information for certain purposes without obtaining separate authorization from you.

These commonly include:

Treatment

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

For example:

A dentist may review your X-rays when planning treatment.
We may share information with a dental specialist involved in your care.
We may communicate with an oral surgeon, physician, laboratory, pharmacy, or other healthcare professional when necessary for your treatment.
We may share information among members of the Avion Dental clinical team involved in your care.

Payment

We may use and disclose your information to obtain payment for dental services.

For example, we may provide information to:

Dental insurance companies
Health insurance companies where applicable
Benefit plans
Third-party payment processors
Other entities responsible for payment

This may include information necessary for eligibility verification, claims submission, prior authorization, coverage determination, or collection.

Healthcare Operations

We may use and disclose health information to operate Avion Dental and improve the care we provide.

Examples include:

Quality assessment
Staff training
Practice management
Credentialing
Compliance
Auditing
Patient service improvement
Internal business operations

OTHER WAYS WE MAY USE OR SHARE YOUR INFORMATION

We may also use or disclose your health information when permitted or required by law.

Appointment Reminders and Patient Communications

We may contact you by telephone, voicemail, text message, email, or other permitted methods regarding:

Appointments
Appointment reminders
Treatment
Follow-up care
Scheduling
Treatment plans
Patient services

Please notify Avion Dental if you have specific communication preferences.

Treatment Alternatives and Health-Related Services

We may contact you regarding treatment alternatives, benefits, products, or services that may be relevant to your dental care when permitted by law.

Public Health and Safety

We may disclose health information for certain public health or safety purposes, including:

Preventing or controlling disease
Reporting adverse reactions to medications or medical products
Reporting suspected abuse or neglect when required or permitted
Preventing or reducing a serious threat to health or safety
Complying with public health reporting obligations

Health Oversight Activities

We may disclose information to health oversight agencies for activities authorized by law, such as:

Audits
Inspections
Investigations
Licensure activities
Regulatory oversight

Workers’ Compensation

We may disclose health information as authorized or required for workers’ compensation or similar programs.

Law Enforcement

We may disclose health information to law enforcement officials when permitted or required by applicable law.

Legal Proceedings

We may disclose health information in response to certain:

Court orders
Administrative orders
Subpoenas
Discovery requests
Other lawful processes

Such disclosures will be made only as permitted or required by applicable law.

Coroners, Medical Examiners, and Funeral Directors

We may disclose health information to coroners, medical examiners, or funeral directors when permitted by law.

Organ and Tissue Donation

When applicable, we may disclose information to organizations involved in organ, eye, or tissue donation and transplantation as permitted by law.

Research

We may use or disclose health information for research when the requirements of applicable privacy laws are satisfied.

Business Associates

Avion Dental may contract with outside companies or individuals that perform services for our practice and may need access to protected health information.

Examples may include:

Dental billing providers
Practice-management software providers
Secure data-storage providers
IT providers
Electronic health-record providers
Claims-processing services
Certain communication or administrative service providers

When required by HIPAA, these organizations are known as Business Associates and must enter into agreements requiring them to appropriately safeguard protected health information.

SUBSTANCE USE DISORDER RECORDS

To the extent Avion Dental maintains patient records that are specifically protected by 42 CFR Part 2 regarding substance use disorder treatment, additional privacy protections may apply.

Such records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against a patient except as specifically permitted by applicable law, authorization, or court order.

OUR RESPONSIBILITIES

Avion Dental is required by law to:

Maintain the privacy and security of your protected health information.
Provide you with this Notice describing our legal duties and privacy practices.
Follow the privacy practices described in the Notice currently in effect.
Notify affected individuals as required by law if a breach occurs that may have compromised the privacy or security of protected health information.

We will not use or disclose your protected health information in ways not described in this Notice unless you authorize us to do so in writing or applicable law otherwise permits or requires the use or disclosure.

If you give us written authorization, you may generally revoke that authorization in writing at any time.

ELECTRONIC COMMUNICATIONS

Avion Dental may communicate with patients using telephone calls, email, text messaging, patient portals, or other electronic methods where permitted.

Electronic communications can carry privacy risks.

If you request or authorize communications using a particular method, Avion Dental will make reasonable efforts to honor your communication preferences in accordance with applicable law and our security practices.

SECURITY OF YOUR INFORMATION

Avion Dental uses administrative, technical, and physical safeguards designed to protect electronic and paper health information.

Access to patient information is limited to authorized persons who require access for appropriate purposes.

No electronic information system can be guaranteed to be completely secure, but we maintain safeguards as required by applicable privacy and security laws.

CHANGES TO THIS NOTICE

We reserve the right to change the terms of this Notice and our privacy practices.

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

When material revisions are made, the current Notice will be:

Available at Avion Dental
Available upon request
Posted on our website when required

The effective date of the current Notice appears at the top of this document.

CONTACT AVION DENTAL ABOUT YOUR PRIVACY RIGHTS

If you have questions about this Notice, wish to exercise one of your privacy rights, request medical or dental records, or submit a privacy complaint, contact:

HIPAA Privacy Officer
Avion Dental
4665 Chino Hills Pkwy, Suite D
Chino Hills, CA 91709

Phone: (909) 597-3445
Email: aviondental@gmail.com
Website: AvionDental.com

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