Notice of Privacy Practices (HIPAA)

Sand Hill Dental Care 

Effective Date: December 8, 2025

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 

You have the right to: 

• Get a copy of your health records 

You can request to see or get a copy of your dental and health records. 

• Ask us to correct your records 

You may request corrections if you believe information is incorrect or incomplete. 

• Request confidential communications 

You can ask us to contact you in a specific way (for example, only by phone or email). 

• Ask us to limit what we use or share 

You may request restrictions on how your information is used or shared. 

• Get a list of who we’ve shared your information with 

You can request an accounting of disclosures. 

• Get a copy of this notice 

You can request a paper copy at any time. 

• Choose someone to act for you 

If you have given someone medical power of attorney, they may exercise your rights. 

• File a complaint 

If you believe your rights have been violated, you may file a complaint without fear of retaliation.

Your Choices 

You have choices in how we use and share your information for: 

• Appointment reminders 
• Treatment alternatives 
• Health-related benefits and services 

You may tell us your preferences for these communications. 

Our Uses and Disclosures 

We may use and share your information in the following ways: 

1. For Treatment 

To provide, coordinate, or manage your dental care. 

2. For Payment 

To bill and receive payment from insurance companies or other payers. 

3. For Healthcare Operations 

To run our practice, improve care, and contact you when necessary. 

4. Other Uses and Disclosures 

We may also share your information: 

• When required by law 
• For public health and safety concerns 
• For health oversight activities 
• In response to legal requests (such as court orders)

Our Responsibilities 

We are required by law to: 

• Maintain the privacy and security of your protected health information 
• Notify you if a breach occurs 
• Follow the duties and privacy practices described in this notice 
• Not use or share your information other than as described here unless you tell us we can 

Changes to This Notice 

We can change the terms of this notice, and the changes will apply to all information we have about you. The updated notice will be available upon request and on our website. 

Contact Information 

If you have questions or would like to exercise your rights, please contact: 

Sand Hill Dental Care 

7903 Silicon Heights

Colorado Springs, CO 80939

(719) 354-2900

Info@JAMIM.Dental

File a Complaint 

You may file a complaint with our office or with the U.S. Department of Health and Human Services if you believe your rights have been violated. 

We will not retaliate against you for filing a complaint.