Privacy & legal
HIPAA Notice of Privacy Practices
How we may use and disclose your health information, and your rights over it.
DRAFT — PENDING LEGAL REVIEW
This document is a working draft. It has not been reviewed or approved by an attorney, and highlighted items are still to be confirmed. It does not constitute legal advice and no claim of legal compliance is made. Last updated October 23, 2026.
This page is not yet the complete Notice. Our formal HIPAA Notice of Privacy Practices is being finalised from the current U.S. Department of Health and Human Services model and reviewed against our actual practices. We would rather say that plainly than publish a notice that is incomplete.
How to get the Notice today
A copy is available at the front desk, and we will provide one at your first appointment. You can also request a copy at any time by calling 425-353-5854 and we will post or hand you one.
What the Notice covers
- How we may use and disclose protected health information for treatment, payment and healthcare operations.
- Uses and disclosures that require your written authorisation.
- Your rights to access, amend, restrict, and request confidential communications.
- Your right to an accounting of certain disclosures.
- Our legal duties, and how to make a privacy complaint without penalty.
The official HHS model this is built from is published at hhs.gov.
Practice details
Covered provider: [INSERT EXACT LEGAL ENTITY NAME]
Practice name used with patients: Madison Street Dental Clinic
Address: 2121 E Madison St Suite A, Everett, WA 98203
Telephone: 425-353-5854
Privacy Officer: [INSERT NAME OR ROLE]
Notice effective date: [INSERT EFFECTIVE DATE]
Related
See also our Privacy Policy for how this website handles information, and our Consumer Health Data Privacy Policy for Washington consumer health data rights.
Questions about your privacy?
Call the office and ask for the person handling privacy requests.