Notice of Privacy Practices

Effective Date: 02/16/2026

This Notice explains how we may use and share your child’s dental and health information — including certain substance use disorder (SUD) information — and how you can access it.

Our Promise to You

We are required by law to:

  • Keep your child’s health information private and secure
  • Explain our privacy practices
  • Notify you if there is a breach of unsecured information
  • Follow the terms of this Notice

How We Use and Share Information

We may use and share your child’s health information without written permission for the following reasons:

Treatment
To provide dental care such as exams, cleanings, fillings, crowns, referrals, and coordination with other providers.

Payment
To bill and collect payment from insurance plans or from you.

Health Care Operations
To run our practice, improve quality, train staff, and manage our business.

Appointment Reminders & Health Information
We may contact you by phone, text, email, or mail to remind you of appointments or share information about treatment or services.

Family Members & Caregivers
We may share information with parents, legal guardians, or others involved in your child’s care unless you tell us not to.

Legal & Safety Reasons
We may share information when required by law, including public health reporting, court orders, law enforcement, workers’ compensation, or to prevent serious harm.

Special Rules for Substance Use Disorder (SUD) Information

Some health information related to substance use disorder diagnosis or treatment is protected by federal law (42 CFR Part 2) and has extra privacy protections.

  • This information cannot be shared for most reasons without specific written permission, even for treatment or billing
  • We will not disclose SUD treatment information unless:
    • You give written consent, or
    • The law specifically allows or requires it

Once SUD information is disclosed with permission, it may not be shared again unless allowed by law.

Your Rights (Parent or Legal Guardian)

You have the right to:

  • See and get a copy of your child’s records (paper or electronic)
  • Ask us to correct information you believe is wrong
  • Ask for private communication (for example, a different phone number)
  • Limit what we share
    • If you pay in full out-of-pocket, you may ask us not to share that visit with your insurance, and we must honor that request
  • Get a list of certain disclosures
  • Get a paper copy of this Notice
  • File a complaint if you believe privacy rights were violated (no retaliation)

Uses That Require Written Permission

We will only use or share your child’s health information — including SUD-related information — for other reasons if you sign a written authorization. You may cancel that authorization in writing at any time.

Questions or Complaints

Privacy Officer: David Vo, owner
Practice Name: LWPDA, PLLC DBA Lake Worth Children’s Dentistry
Phone: 817-238-6450
Email: info@lwpda.com

You may also file a complaint with the U.S. Department of Health & Human Services, Office for Civil Rights. We will not retaliate against you.