HIPAA Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

1. OUR LEGAL DUTY

Smile American LLC is required by law to maintain the privacy of your Protected Health Information (PHI) and provide you with this Notice.

2. USES AND DISCLOSURES

We may use and disclose your PHI for:

• Treatment
• Payment
• Healthcare operations

We may also disclose information when required by law or for public health and safety purposes.

3. YOUR RIGHTS

You have the right to:

• Access your medical records
• Request corrections
• Request restrictions on certain uses

4. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services.

5. CONTACT

Smile American LLC
316 N John Young Pkwy, Suite 6
Kissimmee, FL 34741