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.