NOTICE OF PRIVACY PRACTICES. THIS NOTICE DESCRIBES 
HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION. PLEASE REVIEW IT CAREFULLY. THE PRIVACY
OF YOUR HEALTH INFORMATION IS IMPORTANT TO US.

OUR LEGAL DUTY. We are required by applicable federal
and state law to maintain the privacy of your health 
information. We are also required to give you this Notice 
about our privacy practices, our legal duties, and your rights 
concerning your health information. We must follow the 
privacy practices that are described in this Notice while it is 
in effect. This Notice takes effect 1/1/2003, and will remain 
in effect until we replace it.
 
We reserve the right to change our privacy practices and the 
terms of this Notice at any time, provided such changes are 
permitted by applicable law. We reserve the right to make the
changes in our privacy practices and the new terms of our
Notice effective for all health information that we maintain,
including health information we created or received before 
we made the changes. Before we make a significant change in 
our privacy practices, we will change this Notice and make 
the new Notice available upon request.
 
You may request a copy of our Notice at any time. For more 
information about our privacy practices, or  for additional 
copies of this Notice, please contact us using the information
listed at the end of this Notice.
 
USES & DISCLOSURES OF HEALTH INFORMATION.
We use and disclose health information about you for 
treatment, payment, and healthcare operations. For example:
  
Treatment:  We may use or disclose your health
information to obtain payment for services we provide to you. 

Payment:  We may use and disclose your health information
to obtain payment for services we provide to you.
 
Healthcare Operations:  We may use and disclose your health
information in connection with our healthcare operations.   
Healthcare operations include quality assessment and 
improvements activities, reviewing the competence or
qualifications of healthcare professionals, evaluating practitioner
and provider performance, conducting training programs, 
accreditation, certification, licensing or credentialing activities.
 
Your Authorization:  In addition to our use of your health
information for treatment, payment of healthcare operations, 
only you may give us written authorization to use your health 
information or to disclose it to anyone for any purpose. If you 
give us an authorization, you may revoke it in writing at any 
time. Your revocations will not affect any use or disclosures 
permitted by your authorization while it was in effect. Unless 
you give us a written authorization, we cannot use or disclosed 
your health information for any reason except those described 
in this Notice.
 
To Your Family and Friends:  We must disclose your health
information to you, as described in the Patient Rights section 
of this Notice.   We may disclose your health information to a 
family member, friend or other person to the extent necessary
to help with your healthcare or with payment for your 
healthcare, but only if you agree that we may do so.

Persons Involved in Care:  We may use or disclose health 
information to notify, or assist in the notification of 
(including identifying or locating) a family member, your 
personal representative or another person responsible for your 
care, of your location, your general condition, or death. If you
are present, then prior to use or disclosure of your health 
information, we will provide you with an opportunity to 
object to such uses or disclosures. In the event of your
incapacity or emergency circumstances, we will disclose health
information based on a determination using our professional 
judgment disclosing only health information that is directly
relevant to the persons involvement in your healthcare. We will 
also use our professional judgment and our experience with
common practice to make reasonable inferences of your best
interest in allowing a person to pick up filled prescriptions,
medical supplies, x-rays, or other similar forms of health
information. 

Marketing Health-Related Services:  We will not use your 
health information for marketing communications without
your written authorization.

Required by Law:  We may use or disclose your health 
information when we are required to do so by law.

Abuse or Neglect:  We may disclose your health information 
to appropriate authorities if we reasonably believe that you
are a possible victim of abuse, neglect, or domestic violence 
or the possible victim of other crimes. We may disclose your
health information to the extent necessary to avert a serious
threat to your health or safety or the health or safety of others.
 
National Security:  We may disclose to military authorities
the health information of Armed Forces personnel under certain
circumstances. We may disclose to authorized federal officials
health information required for lawful intelligence, 
counterintelligence, and other national security activities. 
We may disclose to correctional inof inmate or patient under
certain circumstances.
 
Appointment Reminders:  We may use or disclose your health
information to provide you with appointment reminders 
(such as voicemail messages, postcards, or letters).

PATIENT RIGHTS.  
Access:  You have the right to look at or get copies of you
health information, with limited exceptions. You may request
that we provide copies in a format other than photocopies.
We will use the format you request unless we cannot practically
do so. (You must make a request in writing to obtain access 
to your health information. You may obtain a form to request 
access by using the contact information listed at the end of 
this Notice. We will charge you a reasonable cost-based fee for 
expenses such as copies and staff time. You may also request 
access by sending us a letter to the address at the end of this 
Notice. Contact us using the information listed at the end of 
this Notice for a full explanation of our fee structure.
 
Disclosure Accounting:  You have the right to receive a list of 
instance in which we or our business associates disclosed your
health information for purposes, other than treatment, 
payment, healthcare operations and certain other activities, 
for the last 6 years, but not before April 14, 2003. If you 
request this accounting more than once in a 12-month period, 
we may charge you a reasonable, cost-based fee for responding
to these additional requests.
 
Restriction:  You have the right to request that we place
additional restrictions on our use or disclosure of your health 
information.  We are not required to agree to these additional 
restrictions, but if we do, we will abide by our agreement 
(except in an emergency).
 
Alternative Communication:  You have the right to request 
that we communicate with you about your health information
by alternative means or to alternative locations. (You must 
make your request in writing).  Your request must specify the
alternative means or locations, and provide satisfactory 
explanation how payment will be handled under the alternative
means or location you request.
 
Amendment:  You have the right to request that we amend
your health information. (Your request must be in writing,
and it must explain why the information should be amended.)
We may deny your request under certain circumstances.
 
Electronic Notice:  If you receive this Notice on our Web Site 
or by electronic mail (e-mail), you are entitled to receive this 
Notice in written form.
 
QUESTIONS AND COMPLAINTS.  If you want more
information about our privacy practices or have questions
or concerns, please contact us. If you are concerned that we
may have violated your privacy rights, or you disagree with
a decision we made about access to your health information 
or in response to a request you made to amend or restrict the
use of disclosure of your health information or to have us 
communicate with you by alternative means or at alternative
locations, you maycommunicate with us using the contact 
information listed at the end of this Notice.  You also may
submit a written complaint to the U.S. Department of Health
and Human Services. We will provide you with the address
to file your complaint with the U.S. Department of Health 
and Human Services upon request. We support your right to 
the privacy of your health information. We will not retaliate 
in any way if you chose to file a complaint with us or with 
U.S. Department of Health and Human Services.

Contact Officer: Linda
Address: 345 Estudillo Ave. Ste.102, San Leandro, CA. 94577
Email: Linda@Nice-Teeth.com
Telephone: 510.483.2164
Fax: 510.483.1671