HIPAA Privacy Policy

Our Legal Duty

We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices while it is in effect. This notice takes effect upon posting and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law, and to make those changes effective for all health information we maintain, including information created or received before the change. Before making a significant change, we will update this Notice and make the new version available upon request.

You may request a copy of our Notice at any time. For more information about our privacy practices, contact us using the information at the end of this Notice.

Uses and Disclosures of Health Information

We use and disclose health information about you for treatment, payment, and healthcare operations. For example:

Treatment: We may use or disclose your health information to a physician or other healthcare provider treating you.

Payment: We may use and disclose your health information to obtain payment for services we provide.

Healthcare Operations: Healthcare operations include quality assessment and improvement, reviewing the competence of healthcare professionals, evaluating performance, training, accreditation, certification, licensing, and credentialing.

Your Authorization: Beyond treatment, payment, or healthcare operations, you may give us written authorization to use or disclose your health information for any purpose. You may revoke that authorization in writing at any time, though the revocation will not affect disclosures already made in reliance on it.

To Your Family and Friends: We may disclose your health information to a family member, friend, or other person involved in your care or payment for care, but only if you agree that we may do so, as described in the Patient Rights section below.

Persons Involved in Care: We may use or disclose health information to notify or help locate a family member, personal representative, or other person responsible for your care of your location, general condition, or death, using our professional judgment when you’re not present or in an emergency.

Marketing: We will not use your health information for marketing communications without your written authorization.

Required by Law: We may use or disclose your health information when required to do so by law.

Abuse or Neglect: We may disclose your health information to appropriate authorities if we reasonably believe you are a possible victim of abuse, neglect, domestic violence, or another crime, or to avert a serious threat to health or safety.

National Security: We may disclose health information of Armed Forces personnel or to authorized federal officials for lawful national security activities, or to correctional or law-enforcement officials having lawful custody of a patient or inmate, under certain circumstances.

Appointment Reminders: We may use or disclose your health information to provide appointment reminders, such as voicemail messages, postcards, or letters.

Patient Rights

Access: You have the right to look at or get copies of your health information, with limited exceptions, and to request an alternative format. We may charge a reasonable, cost-based fee for copies and staff time.

Disclosure Accounting: You have the right to receive a list of certain disclosures of your health information for the last six years, subject to a reasonable fee for repeated requests within a 12-month period.

Restriction: You have the right to request additional restrictions on our use or disclosure of your health information. We are not required to agree, but if we do, we will abide by our agreement except in an emergency.

Alternative Communication: You have the right to request that we communicate with you by alternative means or at alternative locations (in writing, specifying the alternative and how payment will be handled).

Amendment: You have the right to request that we amend your health information, in writing, with an explanation of why the amendment is needed. We may deny the request under certain circumstances.

Electronic Notice: If you receive this Notice on our website or by email, you are entitled to receive it in written form as well.

Questions and Complaints

If you want more information about our privacy practices, or have questions or concerns, please contact us. If you believe we may have violated your privacy rights, or disagree with a decision we made about access to your health information, you may complain to us using the contact information below. You may also submit a written complaint to the U.S. Department of Health and Human Services; we will provide the address upon request. We will not retaliate against you for filing a complaint.

Smiles On Church
48 Church Street
(Crestline Village in Mountain Brook)
Birmingham, AL 35213
Call: New Patients: (205) 583-0086; Existing: (205) 871-7361