Notice of Privacy Practices

Ramsey Orthodontics (Orthodontic Arts LLC)

284 N. Franklin Turnpike, Ramsey, NJ 07446

Phone: 201-612-1322 · ramseyortho.com

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.

Effective Date: October 22, 2026

Questions or complaints? Contact our Privacy Officer, Dr. David Coleman, at 201-612-1322 or smile@ramseyortho.com.

Your Information. Your Rights. Our Responsibilities.

You have the right to: get a copy of your paper or electronic record; correct your record; request confidential communication; ask us to limit the information we share; get a list of those with whom we’ve shared your information; get a copy of this notice; choose someone to act for you; and file a complaint if you believe your privacy rights have been violated.

You have some choices in how we use and share information as we tell family and friends about your care, provide disaster relief, and market our services.

We may use and share your information as we: treat you; run our practice; bill for your services; help with public health and safety issues; do research; comply with the law; respond to organ and tissue donation requests; work with a medical examiner or funeral director; address workers’ compensation, law enforcement, and other government requests; and respond to lawsuits and legal actions.

To the extent that we have your substance use disorder patient records subject to 42 CFR Part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your record

You can ask to see or get an electronic or paper copy of your orthodontic record and other health information we have about you, including X-rays, photographs, and scans. Ask us how to do this.
We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your record

You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address.
We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If we agree, we may still share the information if you need emergency treatment.
If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information with your health insurer for payment or our operations. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
We will include all disclosures except those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

If someone has authority to act as your personal representative, such as the parent or legal guardian of a minor patient or someone with your medical power of attorney, that person can exercise your rights and make choices about your health information.
We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting our Privacy Officer at 201-612-1322 or smile@ramseyortho.com.
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/hipaa/filing-a-complaint.
We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

Share information with your family, close friends, or others involved in your care or payment for your care
Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

Marketing purposes, including use of your photographs or before-and-after images in advertising, on our website, or on social media
Sale of your information
Most sharing of psychotherapy notes

Our Uses and Disclosures

How do we typically use or share your health information?

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: We send your X-rays and treatment progress to your general dentist or to an oral surgeon who is helping with your care.

Run our practice

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use your information to schedule appointments and send you appointment reminders.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your dental insurance plan so it will pay for your orthodontic treatment.

How else can we use or share your health information?

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. In all cases, if we have substance use disorder patient records about you subject to 42 CFR Part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.

Help with public health and safety issues

We can share health information about you for certain situations such as: preventing disease; helping with product recalls; reporting adverse reactions to medications; reporting suspected abuse, neglect, or domestic violence; and preventing or reducing a serious threat to anyone’s health or safety.

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you: for workers’ compensation claims; for law enforcement purposes or with a law enforcement official; with health oversight agencies for activities authorized by law; and for special government functions such as military, national security, and presidential protective services.

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

New Jersey law

New Jersey law places greater limits on some information. We will not disclose information about HIV/AIDS status or the results of genetic testing without your written consent, except as New Jersey law specifically permits.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
We never sell your health information.

For more information, see www.hhs.gov/hipaa.

Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

Privacy Officer

Dr. David Coleman

Ramsey Orthodontics (Orthodontic Arts LLC)

284 N. Franklin Turnpike, Ramsey, NJ 07446

Phone: 201-612-1322

Email: smile@ramseyortho.com

Effective Date: October 22, 2026