HIPAA Notice of Privacy Practices

Template notice: This is a first-pass document for build purposes and must be reviewed and finalized by qualified legal counsel before launch.

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.

Our commitment

Your custom guard is created under the care of Dr. Jessica Delgado, DDS, MS. Any protected health information (PHI) you provide for that care is captured and stored only on our HIPAA-secure practice-management system — never on the ReeBite website.

How we may use and disclose PHI

Treatment — to design, fabricate, and fit your mouthguard.
Payment — to bill and process payment (payment card data is handled separately and contains no clinical detail).
Health care operations — to run and improve our practice.
As required by law.

Your rights

Inspect and request a copy of your records
Request a correction
Request restrictions or confidential communications
Receive an accounting of certain disclosures
Receive a paper copy of this notice

Our duties

We are required by law to maintain the privacy of your PHI, provide this notice, and follow its terms.

Questions or complaints

Contact our Privacy Officer at admin@mifamilybraces.com or (248) 528-3300. You may also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate for filing a complaint.