Privacy Policy

This privacy notice discloses the privacy practices for this website. This privacy notice applies solely to information collected by this web site. It will notify you of the following:

• What personally identifiable information is collected from you through the web site, how it is used and with whom it may be shared.
• What choices are available to you regarding the use of your data.
• The security procedures in place to protect the misuse of your information.
• How you can correct any inaccuracies in the information.

Information Collection, Use, and Sharing

We are the sole owners of the information collected on this site. We only have access to/collect information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone.

We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request, e.g. to ship an order.

Unless you ask us not to, we may contact you via email in the future to tell you about specials, new products or services, or changes to this privacy policy.

Your Access to and Control Over Information

You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the contact form on our website:

• See what data we have about you, if any.
• Change/correct any data we have about you.
• Have us delete any data we have about you.
• Express any concern you have about our use of your data.

Security

Please do not use our contact form to email us confidential information. While we will not disclose this information to anyone, it could possibly be intercepted by unauthorized entities.

Cookies

We use "cookies" on this site. A cookie is a piece of data stored on a site visitor's hard drive to help us improve your access to our site and identify repeat visitors to our site. For instance, when we use a cookie to identify you, you would not have to log in a password more than once, thereby saving time while on our site. Cookies can also enable us to track and target the interests of our users to enhance the experience on our site. Usage of a cookie is in no way linked to any personally identifiable information on our site.

Links

This web site contains links to other sites. Please be aware that we are not responsible for the content or privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of any other site that collects personally identifiable information.

If you feel that we are not abiding by this privacy policy, you should contact us immediately.

 

NOTICE OF PRIVACY PRACTICES
NORTHBOROUGH FAMILY DENTAL

Effective Date: 02/16/2026

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. The privacy of

your medical information is important to us.

CONTACT INFORMATION
For more information about our privacy practices, to discuss questions or concerns, or
to get additional copies of this notice, please contact our Privacy Officer.
Telephone: 508-393-2522
273 Southwest Cutoff
Northborough, MA 01532

OUR LEGAL DUTY
We are required by law to protect the privacy of your protected health information (“medical
information”). We are also required to send you this notice about our privacy practices, our legal
duties and your rights concerning your medical information.

We must follow the privacy practices that are described in this notice while it is in effect. This
notice takes effect on the date set forth at the top of this page and will remain in effect unless we
replace it. We reserve the right at any time to change our privacy practices and the terms of this
notice at any time, provided such changes are permitted by applicable law. We reserve the right
to make any change in our privacy practices and the new terms of our notice applicable to all
medical information we maintain, including medical information we created or received before
we made the change in practices.

We may amend the terms of this notice at any time. If we make a material change to our policy
practices, we will provide to you, the revised notice. Any revised notice will be effective for all
health information we maintain. The effective date of a revised notice will be noted. A copy of
the current notice in effect will be available in our facility and on our website. You may request a
copy of the current notice at any time. We collect and maintain oral, written and electronic
information to administer our business and to provide products, services and information of
importance to our patients. We maintain physical, electronic and procedural safeguards in the
handling and maintenance of our patients’ medical information, in accordance with applicable
state and federal standards, to protect against risks such as loss, destruction and misuse.

USES AND DISCLOSURES OF YOUR MEDICAL INFORMATION
Treatment: We may disclose your medical information, without your prior approval, to another
dentist or healthcare provider working in our facility or otherwise providing you treatment for the
purpose of evaluating your health, diagnosing medical conditions and providing treatment. For
example, your health information may be disclosed to an oral surgeon to determine whether
surgical intervention is needed.

Payment: We provide dental services. Your medical information may be used to seek payment
from your insurance plan or from you. For example, your insurance plan may request and
receive information on dates that you received services at our facility in order to allow your
employer to verify and process your insurance claim.

Health Care Operations: We may use and disclose your medical information, without your prior
approval, for health care operations. Health care operations include:

• healthcare quality assessment and improvement activities;
• reviewing and evaluating dental care provider performance, qualifications and
competence, health care training programs, provider accreditation, certification, licensing
and credentialing activities;
• conducting or arranging for medical reviews, audits and legal services, including fraud
and abuse detection and prevention; and
• business planning, development, management and general administration including
customer service, complaint resolutions and billing, de-identifying medical information, and
creating limited data sets for health care operations, public health activities and research.

We may disclose your medical information to another dental or medical provider or to your
health plan subject to federal privacy protection laws, as long as the provider or plan has had a
relationship with you and the medical information is for that provider’s or health plan’s care
quality assessment and improvement activities, competence and qualification evaluation and
review activities, or fraud and abuse detection and prevention.

Your Authorization: You (or your legal personal representative) may give us written
authorization to use your medical information or to disclose it to anyone for any purpose. Once
you give us authorization to release your medical information, we cannot guarantee that the
person to whom the information is provided will not disclose that information. You may take back
or “revoke” your written authorization at any time, except if we have already acted based on
your authorization. Your revocation will not affect any use or disclosure permitted by your
authorization while it was in effect. Unless you give us written authorization, we will not use or
disclose your medical information for any purpose other than those described in this notice. We
will obtain your authorization prior to using your medical information for marketing, fundraising
purposes or for commercial use. Once authorized, you may opt out of these communications at
any time.

Family, Friends and Others involved in your care or payment for care: We may disclose
your medical information to a family member, friend or any other person you involve in your care
or payment for your health care. We will disclose the medical information that is relevant to the
person’s involvement.

We may use or disclose your name, location and general condition to notify, or to assist an
appropriate public or private agency to locate and notify, a person responsible for your care in
appropriate situations, such as a medical emergency or during disaster relief efforts.
We will provide you with an opportunity to object to these disclosures, unless you are not
present or are incapacitated or it is an emergency or disaster relief situation. In those situations,
we will use our professional judgment to determine whether disclosing your medical information
is in your best interest under the circumstances.

Health-Related Products and Services: We may use your medical information to
communicate with you about health-related products, benefits, services, payment for those
products and services and treatment alternatives.

Reminders: We may use or disclose medical information to send you reminders about your
dental care, such as appointment reminders via US Mail, email and telephone. By providing
your email address to us, you agree that you may receive reminders and breach notifications via
email as a possible alternative to US Mail. It is the policy of our office to leave a message on
any voicemail or answering machine that may be attached to a number that you provide (home,
cell or work). If you prefer that we NOT leave a message to confirm treatment or your
appointments, please notify us in writing at the above office address.

Plan Sponsors: If your dental insurance coverage is through an employer’s sponsored group
dental plan, we may share summary health information with the plan sponsor.
Public Health and Benefit Activities: We may use and disclose your medical information,
without your permission, when required by law and when authorized by law for the
following kinds of public health and public benefit activities;
• for public health, including to report disease and vital statistics, child abuse, adult abuse,
neglect or domestic violence;
• to avert a serious an imminent threat to health or safety;
• for health care oversight, such as activities of state insurance commissioners, licensing
and peer review authorities and fraud prevention agencies;
• for research;
• in response to court and administrative orders and other lawful process;
• to law enforcement officials with regard to crime victims and criminal activities;
• to coroners, medical examiners, funeral directors and organ procurement organizations;
• to the military, to federal officials for lawful intelligence, counterintelligence, and national
security activities, and to correctional institutions and law enforcement regarding persons
in lawful custody; and
• as authorized by state worker’s compensation laws.

Special protections for SUD records: Substance Use Disorder (SUD) Treatment records have
enhanced protections. They cannot be used in legal proceedings without your consent or court
order.

If the use or disclosure of health information described above in this notice is prohibited or
materially limited by other laws that apply to us, it is our intent to meet the requirements of the
more stringent law.

Business Associates: We may disclose your medical information to our business associates
that perform functions on our behalf or provide us with services if the information is necessary
for such functions or services. Our business associates are required, under contract with us, to
protect the privacy of your information and are not allowed to use or disclose any information
other than as specified in our contract.

Data Breach Notification Purposes: We may use your contact information to provide legally
required notices of unauthorized acquisition, access or disclosure of your health information.
Additional Restrictions on use and disclosure: Certain federal and state laws may require
special privacy protections that restrict the use and disclosure of certain health information,
including highly confidential information about you. “Highly Confidential Information” may include
confidential information under Federal laws governing reproductive rights, alcohol and drug
abuse information and genetic information as well as state laws that often protect the following
types of information:

1) HIV/AIDS;
2) Mental Health;
3) Genetic Tests (in accordance with GINA 2009);
4) Alcohol and drug abuse;
5) Sexually transmitted diseases and reproductive health information; and
6) Child or adult abuse or neglect, including sexual assault.
YOUR RIGHTS
1) You have a right to see and get a copy of your health records.
2) You have a right to amend your health information.
3) You have a right to ask to get an Accounting of Disclosures of when and why your
health information was shared for certain purposes.
4) You are entitled to receive a Notice of Privacy Practices that tells you how your health
information may be used and shared.

5) You may decide if you want to give your Authorization before your health information
may be used or shared for certain purposes, such as marketing. It is the policy of our
office NOT to sell or disclose your information to any outside firms or business partners.
Your information may be used, only within our office, for the purposes of presenting to you
certain products or services which our dentist(s) or staff feel may present a benefit for you,
your oral health or happiness with your smile. If you would like to opt out of this level of
service, you may do so in writing at the above office address.
6) You have the right to receive your information in a confidential manner and restrict
certain communication methods.
7) You have a right to restrict who receives your information.
8) You have a right to request an amendment to be made to your health records by
submitting the request in writing to our privacy officer. Your request does not guarantee the
amendment, but does guarantee that it will be reviewed and considered.
9) If you believe your rights are being denied or your health information is not being
protected, you can:
a. File a complaint with your provider or health insurer
b. File a complaint with the U.S. Government
10) Right to opt out of fundraising activities. If you would like to opt out of any fundraising
programs that our office may participate in, such as cancer walks, or other fundraising
programs you may do so in writing at the above office address.

COMPLAINTS
If you are concerned that we may have violated your privacy rights, or you disagree with a
decision we made about access to your medical information, about amending your medical
information, about restricting our use or disclosure of your medical information, or about how we
communicate with you about your medical information (including a breach notice
communication), you may contact our Privacy Officer to register either a verbal or written
complaint. You may also submit a written complaint to the Office for Civil Rights of the United
States Department of Health and Human Services, 200 Independence Avenue, SW, Room
509F, Washington, DC, 20201. You may contact the Office for Civil Rights’ hotline at
1-800-368-1019. We support your right to privacy of your medical information. We will not
retaliate in any way if you choose to file a complaint with us or with the US Department of Health
and Human Services.