HIPAA Notice of Privacy Practices

Dental Sedation Center of Connecticut
Effective Date: March 13, 2026

Your Information. Your Rights. Our Responsibilities.

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.

Dental Sedation Center of Connecticut (“DSCC,” “we,” “our,” or “us”) is required by law to maintain the privacy and security of your protected health information (PHI).

Protected Health Information includes information about your health condition, treatment, payment for services, and personal identifiers such as your name, address, or date of birth.

Your Rights

You have certain rights regarding your health information.

Get a Copy of Your Health Records

You can ask to see or receive a copy of your health records and other medical information we maintain about you.

  • Requests must be submitted in writing.
  • We may charge a reasonable fee for copies.

Ask Us to Correct Your Medical Record

You can request that we correct health information you believe is incorrect or incomplete.

We may deny your request, but we will provide a written explanation.

Request Confidential Communications

You may request that we contact you in a specific way, such as:

  • Calling only a specific phone number
  • Sending mail to a different address

We will accommodate reasonable requests.

Ask Us to Limit What We Use or Share

You can ask us not to use or share certain health information for treatment, payment, or healthcare operations.

While we will consider all requests, we are not required to agree unless the request relates to a service that has been paid for out-of-pocket in full.

Get a List of Disclosures

You may request a list of certain disclosures we have made of your health information.

This list will include disclosures made in the previous six years, except those related to treatment, payment, healthcare operations, or certain other permitted disclosures.

Get a Copy of This Notice

You may request a paper copy of this notice at any time, even if you have agreed to receive it electronically.

Choose Someone to Act for You

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights regarding your health information.

File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with:

Dental Sedation Center of Connecticut
or
The U.S. Department of Health and Human Services Office for Civil Rights.

You will not be penalized for filing a complaint.

How We May Use and Share Your Health Information

We typically use or share your health information in the following ways.

For Treatment

We may use your health information to provide and coordinate your care.

Example:
A dentist treating you for sedation dentistry may share information with another healthcare provider involved in your care.

For Payment

We may use or share your information to bill and receive payment for services.

Example:
Sharing information with your insurance provider to obtain reimbursement for treatment.

For Healthcare Operations

We may use your information to operate our practice, improve care, and manage administrative functions.

Example:

  • Quality improvement activities
  • Staff training
  • Business management and administrative functions

Other Ways We May Use or Share Your Information

We may also share your health information for the following purposes:

Public Health and Safety

To prevent disease, report adverse reactions, or assist public health authorities.

Health Oversight Activities

For audits, inspections, and licensing activities required by law.

Legal Requirements

If required by federal, state, or local law.

Law Enforcement

When required for certain law enforcement purposes.

Judicial and Administrative Proceedings

In response to court orders or legal processes.

Workers’ Compensation

To comply with workers’ compensation laws.

Coroners, Medical Examiners, and Funeral Directors

As required for identification or cause-of-death purposes.

Situations Requiring Your Written Permission

We will obtain your written authorization before using or sharing your health information for:

  • Marketing purposes
  • Sale of health information
  • Most uses involving psychotherapy notes

You may revoke your authorization at any time in writing.

Our Responsibilities

Dental Sedation Center of Connecticut is required by law to:

  • Maintain the privacy and security of your protected health information
  • Provide you with this notice of our legal duties and privacy practices
  • Follow the terms of the notice currently in effect
  • Notify you if a breach occurs that may have compromised the privacy or security of your information

Changes to This Notice

We may change the terms of this notice at any time.

Any updated notice will apply to all information we maintain and will be posted on our website.

Contact Information

If you have questions about this notice or your privacy rights, please contact:

Dental Sedation Center of Connecticut
Website: https://dentalsedationct.com
Phone: (860) 561-1233
Address: 501 Kings Highway East, Suite 401, Fairfield, CT 06825

File a Complaint with HHS

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

Office for Civil Rights
https://www.hhs.gov/ocr/privacy/hipaa/complaints/

You will not be penalized for filing a complaint.