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. PLEASE REVIEW IT CAREFULLY.

Effective date: May 11, 2026

Rinse Dental, operated by Skylark Partners LLC, is a covered entity under the Health Insurance Portability and Accountability Act ("HIPAA"). "PHI" means individually identifiable health information about you that we create, receive, or maintain.

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How we may use and disclose your PHI

Without your authorization, we may use or disclose your PHI to:

Treat you — for example, share records with a referring specialist.
Obtain payment — for example, submit claims to your dental insurance.
Operate our practice — for example, quality review, training, and audits.
Comply with law — including public health reporting; reporting abuse, neglect, or domestic violence; court orders and subpoenas; law enforcement requests; workers' compensation; health oversight; coroners and medical examiners; research approved by an Institutional Review Board; and to avert serious threats to health or safety.
Communicate with family or friends involved in your care, unless you object.
Send appointment reminders, treatment alternatives, and information about health-related services we offer. You may opt out of these.

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With your written authorization, we may use or disclose PHI for marketing, sale of PHI, psychotherapy notes, and any other purpose not listed above. You may revoke an authorization in writing at any time, except where we have already acted in reliance on it.

Your rights

You have the right to:

Inspect and copy your records. We will respond within 30 days. A reasonable, cost-based fee may apply consistent with HIPAA and Fla. Stat. § 456.057.
Request an amendment if you believe a record is inaccurate or incomplete.
Receive an accounting of disclosures other than those made for treatment, payment, or healthcare operations.
Request restrictions on how we use or disclose your PHI. We are not required to agree to most restrictions, but we must agree to restrict disclosure to a health plan for services you have paid for in full out of pocket.
Request confidential communications at a specific phone number or address.
Receive a paper copy of this Notice.
Be notified if a breach of your unsecured PHI occurs.
Designate someone to act on your behalf (legal guardian or healthcare power of attorney).

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To exercise any right, contact our Privacy Officer below.

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Our duties

We are required by law to maintain the privacy of PHI, provide this Notice, abide by its current terms, and notify you following a breach of your unsecured PHI. We reserve the right to change this Notice, and any changes will apply to all PHI we maintain. The current Notice will be posted in our office and on our website.

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Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

U.S. Department of Health and Human Services, Office for Civil Rights

‍200 Independence Avenue, S.W.

Washington, D.C. 20201

877-696-6775

‍https://www.hhs.gov/ocr/complaints/

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