Floss Boss Pediatric Dentistry
Effective Date: [14/10/2026]
Legal Name of HIPAA Covered Entity:
Flemington location is Floss Boss Inc.
Hillsborough location is FBI Hillsborough Inc.
Website: https://flossbosspeds.com/
THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Introduction
Floss Boss Pediatric Dentistry respects the privacy of our patients and recognizes the importance of protecting medical, dental, and other health-related information.
This Notice of Privacy Practices (“Notice”) describes how protected health information (“PHI”) may be used and disclosed by the HIPAA-covered entity identified above, the rights individuals have concerning their information, and our legal responsibilities under applicable privacy laws.
This Notice applies to the protected health information maintained by the covered entity and its workforce, as well as those acting on its behalf where applicable.
The identification of the offices, legal entities, and providers covered by this Notice must be confirmed before publication.
Your Rights Regarding Health Information
Under applicable law, you have important rights regarding your health information.
Access Your Records
You may request to inspect or obtain an electronic or paper copy of your dental records and other information contained in your designated record set, subject to applicable exceptions.
We will respond within the timeframes required by law. Permitted, reasonable, cost-based fees may apply to certain copies.
Request Corrections
If you believe information in your record is incorrect or incomplete, you may request an amendment.
We may deny certain requests as permitted by law, but we will provide an explanation in writing when required.
Request Confidential Communications
You may request that we communicate with you through a particular method or at a specific location.
For example, you may request communications at a designated telephone number or mailing address.
We will accommodate reasonable requests as required by law.
Request Restrictions
You may request limitations on how we use or disclose certain health information for treatment, payment, or healthcare operations.
We are not required to agree to every requested restriction.
However, when you pay for a healthcare item or service completely out of pocket, you may request that information about that item or service not be disclosed to your health plan for payment or healthcare operations, unless disclosure is required by law.
Request an Accounting of Disclosures
You may request an accounting of certain disclosures of your health information during the preceding six years, subject to applicable limitations and exclusions.
One accounting within a 12-month period is generally available without charge. Additional requests may be subject to a reasonable, cost-based fee where legally permitted.
Obtain a Copy of This Notice
You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
Designate a Personal Representative
A person legally authorized to act on your behalf may exercise applicable privacy rights, subject to verification of that authority and relevant legal exceptions.
File a Complaint
You may file a privacy complaint with our practice or with the U.S. Department of Health and Human Services Office for Civil Rights.
We will not retaliate against you for exercising your privacy rights or filing a complaint.
Your Choices Regarding Your Information
In certain circumstances, you may have choices concerning how we share your health information.
These may include:
- Sharing information with family members, friends, or others involved in your care or payment for your care.
- Communications related to disaster relief.
- Certain marketing communications requiring authorization.
- Fundraising communications, if our practice conducts such activities.
- Other uses or disclosures for which applicable law provides a choice or requires authorization.
Where written authorization is legally required, we will obtain that authorization before using or disclosing your information.
You may revoke an authorization in writing, subject to applicable legal limitations and actions already taken in reliance on the authorization.
How We May Use and Disclose Health Information
Treatment
We may use and disclose health information to provide, coordinate, or manage dental care.
For example, we may share relevant information with another treating healthcare professional when necessary to coordinate a patient’s care.
Payment
We may use and disclose information to bill and receive payment for dental services.
For example, relevant treatment and billing information may be submitted to a dental insurance plan to process a claim.
Healthcare Operations
We may use and disclose information for legitimate healthcare operations, including practice management, quality assessment, care coordination, staff training, and other activities permitted by law.
For example, treatment records may be reviewed internally to evaluate the quality of care provided.
Appointment Reminders and Health-Related Communications
We may contact patients or authorized representatives concerning appointments, scheduling, treatment alternatives, or other health-related benefits and services when permitted by law.
Communications must comply with applicable privacy requirements and any separately applicable telephone or messaging consent requirements.
Business Associates
We may disclose protected health information to authorized business associates performing services on our behalf, subject to applicable HIPAA requirements and agreements.
Public Health and Safety
We may use or disclose information when authorized or required by law for public health activities, reporting obligations, or to help address serious threats to health or safety.
Abuse or Neglect Reporting
We may disclose information to appropriate authorities when reporting is required or permitted by applicable law, including laws relating to suspected child abuse or neglect.
Health Oversight and Legal Requirements
We may disclose information to authorized oversight agencies or as otherwise required by applicable law.
Research
Health information may be used or disclosed for research only when the applicable legal requirements are met.
Law Enforcement and Judicial Proceedings
We may disclose information in response to legally valid requests or processes when permitted or required by law.
Other Legally Permitted Disclosures
Other circumstances may include workers’ compensation, certain government functions, medical examiners, or other specifically authorized activities, subject to applicable requirements.
Uses and Disclosures Requiring Authorization
Uses or disclosures that are not otherwise permitted or required by law generally require written authorization.
Examples may include:
- Uses or disclosures of PHI for marketing that require authorization.
- Sale of protected health information.
- Most uses or disclosures of psychotherapy notes, if such records are maintained, subject to legal exceptions.
- Other disclosures for purposes not authorized by the applicable privacy rules.
If an authorization is required, we will obtain it before making the relevant use or disclosure.
You may revoke an authorization in writing, subject to applicable legal limitations.
Special Protections for Substance Use Disorder Records
Certain patient records relating to substance use disorder treatment may receive additional federal confidentiality protections under 42 CFR Part 2.
To the extent that our covered entity receives or maintains records subject to Part 2, the use and disclosure of those records must comply with applicable requirements.
In particular, Part 2 records generally cannot be used or disclosed in civil, criminal, administrative, or legislative proceedings against the patient without the required written consent or legally sufficient court process.
Where applicable, additional rules govern patient consent, redisclosure, fundraising, and other uses of these records.
Any state-law confidentiality protections that are more stringent than the applicable federal requirements will also be observed.
Privacy of Minors and Parental Rights
Because Floss Boss Pediatric Dentistry provides pediatric dental care, information about minor patients requires particular attention.
Parents and legal guardians generally may exercise applicable rights concerning a child’s health information when authorized under federal and state law.
However, special rules may apply when minors can legally consent to particular healthcare services, when a parent or guardian is not legally entitled to certain information, or when disclosure presents circumstances addressed by applicable privacy law.
Our practice will evaluate requests for access or disclosure involving minors according to HIPAA, applicable New Jersey law, and the facts of the specific situation.
We may require appropriate verification of legal authority before releasing protected information.
Electronic Communications and Patient Privacy
Our practice may communicate with patients, parents, guardians, and authorized individuals through appropriate channels.
Depending on applicable law, communication preferences, and the nature of the information, these channels may include telephone calls, email, patient communication systems, or text messages.
Ordinary email and SMS may present privacy or security risks.
We will consider applicable confidentiality, security, and authorization requirements when selecting communication methods.
Patients and representatives may request reasonable confidential communication arrangements as provided by law.
Participation in optional SMS programs is separately described in our SMS Terms & Conditions.
Our Legal Responsibilities
Where HIPAA applies, our responsibilities include:
- Maintaining the privacy and security of protected health information.
- Providing individuals with notice of our legal duties and privacy practices.
- Following the terms of the Notice currently in effect.
- Implementing safeguards required by applicable law.
- Notifying affected individuals following breaches of unsecured protected health information when legally required.
- Complying with applicable patient rights and authorization requirements.
We will not use or disclose protected health information for purposes outside those permitted or required by law without the appropriate authorization.
Changes to This Notice
We reserve the right to revise this Notice and, to the extent allowed by law, make the revised Notice effective for protected health information we already maintain as well as information received in the future.
When required, updated versions will be made available in our offices and on our website.
The current Notice will include its effective date.
Questions and Privacy Complaints
If you have questions about this Notice, need help exercising your privacy rights, or wish to file a complaint with our practice, please contact:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Telephone: 1-877-696-6775
https://www.hhs.gov/hipaa/filing-a-complaint/
You will not be retaliated against for filing a privacy complaint.
Practice Contact Information
Floss Boss Pediatric Dentistry
Flemington Office
6 Sand Hill Rd, Suite 203
Flemington, NJ 08822
Phone: (908) 751-0770
Hillsborough Township Office
405 Omni Dr
Hillsborough Township, NJ 08844
Phone: (908) 493-5885
General Email: info@flossbosspeds.com
Website: https://flossbosspeds.com/
Scope and Effective Date
This Notice applies to:
Flemington location is Floss Boss Inc.
Hillsborough location is FBI Hillsborough Inc.
Effective Date: [14/10/2026]
