Privacy Notice

Review the full Privacy Notice here.

Protecting Your Personal Health Information

Your privacy is important to us. This notice explains how your medical information may be used and shared, your rights regarding your health information, and how you can access your records. Please review this information carefully.

How We May Use Your Information

We may use or disclose your protected health information to:

  • Treatment – Coordinate your care with healthcare providers and send appointment reminders.
  • Payment – Process insurance claims and billing.
  • Healthcare Operations – Improve the quality of care, train staff, and manage our practice.
  • Health Information Exchange (HIE) – Share records electronically with participating healthcare providers when appropriate.
  • Business Associates – Work with trusted partners who assist in operating our practice while protecting your privacy.
  • When Required by Law – Comply with federal, state, and local regulations.

Other Situations Where Information May Be Shared

Your information may also be used or disclosed for:

  • Public health and safety
  • Research (when permitted by law)
  • Emergency situations and disaster relief
  • Individuals involved in your care
  • Legal proceedings
  • Workers’ compensation
  • National security or military purposes
  • Artificial intelligence tools that support clinical documentation and operations while maintaining HIPAA protections

Your Privacy Rights

As a patient, you have the right to:

✔ Request a copy of your health records

✔ Request corrections to your records

✔ Receive a list of certain disclosures

✔ Request restrictions on how your information is shared

✔ Receive a paper copy of this notice

✔ Authorize someone to act on your behalf when appropriate

Uses That Require Your Permission

We will obtain your written authorization before using your information for:

  • Psychotherapy notes
  • Marketing purposes
  • Sale of medical information
  • Any other uses not otherwise permitted by law

Changes to This Notice

We may update this Privacy Notice as laws or our privacy practices change. The most current version will always be available at our office and on our website.

Questions or Privacy Concerns?

If you have questions about this notice or believe your privacy rights have been violated, please contact our Privacy Officer:

Dr. Helen K. Peterson
Prime Smile West
2802 Lafayette Rd. #33
Indianapolis, IN 46222
Prime Smile West Phone Number (317) 925-2810

You may also file a complaint with the U.S. Department of Health and Human Services.