HIPAA Notice of Privacy Practices

Effective Date: January 1, 2026  |  Last Revised: January 1, 2026

Our Legal Duty

Sacramento Holistic Dentist (operated by Yana Pekarski, DDS) is required by law to maintain the privacy of your protected health information (PHI) and to provide you with this notice of our legal duties and privacy practices. We are required to abide by the terms of this notice currently in effect.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your dental care. For example, we may share information with a dental specialist or other healthcare provider to whom we refer you.

Payment

We may use and disclose your PHI to obtain payment for dental services. For example, we may send a claim to your dental insurance plan including information about services provided.

Health Care Operations

We may use and disclose your PHI for our practice's health care operations, including quality assessment, staff training, and business planning necessary to run our practice.

Appointment Reminders

We may contact you as a reminder that you have an appointment for dental care or treatment via phone, text, or email, unless you have requested confidential communications.

Treatment Alternatives

We may use and disclose your PHI to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your PHI not covered by this notice or applicable law will be made only with your written authorization. You may revoke any such authorization in writing at any time.

We will not sell your PHI without your authorization. We will not use your PHI for marketing without your authorization, except as permitted by law.

Your Rights Regarding Your Health Information

Right to Inspect and Copy

You have the right to inspect and copy PHI that we maintain about you in a designated record set. We will respond to your request within 30 days. We may charge a reasonable cost-based fee for copies.

Right to Amend

You have the right to request that we amend PHI we maintain about you if you believe it is incorrect or incomplete. We may deny your request under certain circumstances.

Right to an Accounting of Disclosures

You have the right to request an accounting of disclosures we have made of your PHI, except for disclosures for treatment, payment, and operations, and certain other exceptions.

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to your request, except we must agree to a restriction if the disclosure is to a health plan for payment or operations and you have paid out-of-pocket in full.

Right to Request Confidential Communications

You have the right to request that we communicate with you about dental matters in a certain way or at a certain location. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this notice upon request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with our practice, contact us at the information below. You will not be retaliated against for filing a complaint.

Changes to This Notice

We reserve the right to change this notice and the revised notice will apply to all PHI we maintain. The current notice will be posted in our office and on our website.

Contact Our Privacy Officer

Questions or requests regarding your PHI may be directed to:
Sacramento Holistic Dentist
Attn: Privacy Officer — Dr. Yana Pekarski, DDS
5931 Stanley Ave Unit 3, Carmichael, CA 95608
Phone: (916) 507-2122
Email: hello@sacramentoholisticdentist.com