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.
Effective Date: 1/26/2026
This Notice of Privacy Practices (“Notice”) applies to the healthcare services provided by this practice (the “Practice”). The Practice is required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice, and follow the terms of the Notice currently in effect.
We are required by law to:
We may use and disclose your PHI without your authorization for the following purposes:
We may disclose your PHI to business associates that perform services on our behalf, such as billing companies, IT vendors, cloud service providers, shredding services, and legal or accounting firms. Business associates are required by law to protect your PHI and may use or disclose it only as permitted by their contract with us and by law.
We may disclose PHI to a family member, friend, or other person involved in your care or payment for your care, unless you object or we determine it is not in your best interest to do so.
We may use or disclose PHI as required or permitted by law for public health activities, reporting abuse or neglect, health oversight activities, judicial or administrative proceedings, law enforcement purposes, workers’ compensation, and to avert a serious threat to health or safety.
We will not use or disclose PHI for the purpose of investigating or imposing liability related to lawful reproductive health care, including abortion, miscarriage, contraception, or fertility services, as prohibited by federal law.
We will not disclose reproductive health information to law enforcement or other parties without a valid attestation or authorization when required by law.
If applicable, records related to substance use disorder treatment that are protected under 42 CFR Part 2 will be used or disclosed only as permitted by federal law.
If this Practice does not provide SUD diagnosis or treatment, references to substance use documented in your medical record are treated as HIPAA-protected PHI and are not Part 2 records.
We will not use or disclose your PHI for marketing purposes without your written authorization, except as permitted by law. If authorization is required, you may revoke it at any time in writing.
We may use certain limited information (such as your name, address, phone number, and dates of service) to contact you for fundraising purposes. You have the right to opt out of receiving fundraising communications at any time. Your decision to opt out will not affect your treatment or payment for services.
Each fundraising communication will include a clear and simple method for opting out.
You have the right to:
You will be notified if a breach occurs that compromises the privacy or security of your PHI.
Under Oregon law, patients may have additional rights related to
We reserve the right to change this Notice and make the revised Notice effective for PHI we already maintain. The current Notice will be available upon request and posted in our office.
Practice Name: Sleep Dentistry Defined
Privacy Officer or Contact Person:
Phone: 503-646-2273
Email: [email protected]
Address: 14455 SW Allen Blvd. Ste. #103 Beaverton, OR 97005
You may also file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
HIPAA Form 1
© Physician’s Resource 2026