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Timberline Family Dental: 2153 SE LA Grant Pkwy Waukee, IA 50263

Notice of Privacy Practices

Effective Date: August 7th, 2026

This notice explains how Timberline Family Dental may use and disclose your protected health information, and how you can access this information.

Timberline Family Dental is required by law to maintain the privacy of protected health information, provide individuals with notice of our legal duties and privacy practices, and notify affected individuals following a breach of unsecured protected health information.

How We May Use and Disclose Your Information

Timberline Family Dental may use and disclose your protected health information for different purposes, including treatment, payment, and healthcare operations.

Treatment

We may use and disclose your health information to provide, coordinate, or manage your dental care and treatment. For example, we may share relevant information with another healthcare provider involved in your care.

Payment

We may use and disclose your health information to obtain payment for treatment and services. This may include billing, claims management, insurance eligibility, and coverage determinations.

Healthcare Operations

We may use and disclose your health information to support the operation of the practice. This may include quality assessment, improvement activities, training, licensing, and other business activities related to patient care.

Individuals Involved in Your Care

We may share relevant health information with a family member, friend, or other person involved in your care or payment for your care, where permitted by law or authorised by you.

Required by Law

We may use or disclose your health information when required or permitted by law, including for public health activities, health oversight activities, law enforcement purposes, legal proceedings, or to comply with HIPAA requirements.

Other Uses and Disclosures

Uses and disclosures of protected health information not described in this notice will only be made with your written authorisation, unless otherwise permitted or required by law.

You may revoke written authorisation at any time. If you revoke your authorisation, we will stop using or disclosing your protected health information for that purpose, except where action has already been taken based on your authorisation.

Your Health Information Rights

You have certain rights regarding your protected health information. These may include the right to:

Access or request copies of your health records

Request an accounting of certain disclosures of your health information

Request restrictions on certain uses or disclosures

Request communication by alternative means or at an alternative location

Ask us to amend information you believe is incorrect or incomplete

Receive notification if a breach of unsecured protected health information occurs

Receive a paper copy of this notice upon request

Questions and Complaints

If you have questions about this notice or the privacy of your health information, please contact Timberline Family Dental directly.

If you believe your privacy rights have been violated, you may file a complaint with the practice or with the U.S. Department of Health and Human Services. Timberline Family Dental will not retaliate against you for filing a complaint.

Changes to This Notice

Timberline Family Dental may update this notice from time to time. Any updated notice will apply to the protected health information maintained by the practice. The current version will be available on our website and upon request.

Contact Information

If you have questions about this notice or your privacy rights, please contact the practice directly.

Timberline Family Dental

2153 SE LA Grant Pkwy
Waukee, IA 50263
Phone: 515-644-2264
Email: tfdwaukee@gmail.com

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