Notice of Privacy Practices

Effective Date: March 2, 2026

Dr. James Klim, DDS – Santa Rosa, CA

This notice describes how your medical and dental information may be used and disclosed and how you can get access to this information. Please review it carefully.

1. Our Legal Duty

We are required by law to:

Maintain the privacy of your protected health information (PHI).
Provide you with this notice of our legal duties and privacy practices regarding PHI.
Follow the terms of the notice currently in effect.

We reserve the right to change the terms of this notice at any time and to make the new provisions effective for all PHI we maintain. If we make changes, a copy of the revised notice will be available in our office and on our website.

2. How We May Use and Disclose Your PHI

We may use and disclose PHI for purposes of treatment, payment, and healthcare operations:

Treatment: To provide, coordinate, or manage your dental care and related services.
Payment: To obtain payment for services we provide to you.
Healthcare Operations: For business activities, quality assessment, and staff training.

Other uses and disclosures may include:

Appointment reminders via phone, email, or text.
Communications about treatment alternatives or health-related benefits.
Disclosures required by law (e.g., public health, law enforcement).

Special Protections: Certain sensitive information (e.g., substance use disorder records) may require additional consent before disclosure.

3. Your Rights Regarding PHI

You have the right to:

Access: Inspect and obtain a copy of your PHI.
Amend: Request corrections to your PHI.
Accounting of Disclosures: Request a record of disclosures of your PHI.
Request Restrictions: Ask us to limit the use or disclosure of your PHI.
Alternative Communication: Request confidential communications via alternative methods or locations.
Receive a Copy: Obtain a paper or electronic copy of this notice.

To exercise these rights, contact:

Privacy Officer: Debbie Kimura
Phone: 707-546-4582
Email: debbie@jamesklim.com

4. Complaints

If you believe your privacy rights have been violated, you may:

File a complaint with our office.
File a complaint with the U.S. Department of Health and Human Services: https://www.hhs.gov/hipaa/filing-a-complaint/index.html

You will not be retaliated against for filing a complaint.