Tender Loving Care Dentistry
TLC Dentistry · Andrew K. Phan, DMD
Effective Date: September 23, 2026
THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
TLC Dentistry is committed to protecting the privacy and security of your health information.
This Notice describes how we may use and disclose Protected Health Information relating to your dental and health care, explains your rights regarding that information, and describes our responsibilities under HIPAA and other applicable federal and Oregon laws.
You have certain rights regarding your health information.
You may ask to see or obtain an electronic or paper copy of your dental record and other health information we maintain about you.
We will provide access or a copy within the time required by applicable law.
We may charge a reasonable, cost-based fee where permitted by law.
In certain limited circumstances, access may be restricted or denied as permitted by law.
You may ask us to correct information in your dental or health record that you believe is incorrect or incomplete.
We may deny your request in certain circumstances, but if we do, we will explain why in writing as required by law.
You may ask us to contact you in a specific way or at a particular location.
For example, you may ask us to:
We will accommodate reasonable requests.
You may ask us not to use or disclose certain health information for treatment, payment, or health care operations.
We generally are not required to agree to every request.
However, if you pay for a health care service or item completely out-of-pocket and ask us not to disclose that information to your health plan for payment or health care operations, we generally must honor the request unless disclosure is required by law.
You may request an accounting of certain disclosures of your health information made during the six years before your request.
Certain disclosures are not required to appear on the accounting, including many disclosures for:
We will provide one accounting during a 12-month period without charge. A reasonable fee may be charged for additional requests when permitted by law.
You may request a paper copy of this Notice at any time, even if you agreed to receive it electronically.
If another person has legal authority to act on your behalf, such as a legally authorized health care representative or guardian, that person may exercise your privacy rights when permitted by law.
We may verify that person’s legal authority before acting on a request.
If you believe your privacy rights have been violated, you may file a complaint with TLC Dentistry.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.
TLC Dentistry will not retaliate against you for filing a privacy complaint or exercising your rights.
For certain health information, you may tell us your preferences about what we share.
You may tell us whether we may share relevant health information with:
When you are able to make your own decisions, we generally follow your instructions.
If you are unable to communicate your preference, such as during an emergency, we may disclose relevant information when we determine that doing so is in your best interests and is permitted by law.
We may share limited information with an organization assisting with disaster-relief efforts when permitted by law.
If TLC Dentistry conducts fundraising communications permitted under HIPAA, you may tell us not to contact you again for fundraising.
We may use your health information and share it with other health professionals who are involved in your care.
For example, we may provide relevant dental records or X-rays to:
We may use and disclose your health information to obtain payment for services.
For example, we may provide information about dental services to your insurance company so the insurer can determine coverage and process a claim.
We may use and disclose health information to operate and improve our dental practice.
This can include:
We may use appropriate contact information to communicate with you about:
Communications may occur through telephone, voicemail, mail, email, text message, or other appropriate methods.
You may request reasonable confidential communication arrangements.
TLC Dentistry may engage outside companies to perform services on our behalf.
These may include providers of:
When a company performs functions involving Protected Health Information on our behalf and qualifies as a Business Associate under HIPAA, we require appropriate safeguards and agreements as required by law.
We may use or disclose Protected Health Information without written authorization when permitted or required by law.
We may disclose information for authorized public-health purposes, including activities involving:
We may disclose information to appropriate authorities when required or permitted by law concerning suspected abuse, neglect, or domestic violence.
We may use or disclose information when necessary and legally permitted to prevent or lessen a serious and imminent threat to a person or the public.
We may disclose information to authorized health-oversight agencies for activities such as:
We may disclose health information in response to certain:
We will comply with applicable legal requirements governing such disclosures.
We may provide health information to law-enforcement authorities when required or permitted by law.
We may provide information as legally permitted so those individuals can perform their authorized duties.
When applicable, information may be disclosed to organizations involved in organ, eye, or tissue donation and transplantation.
We may disclose health information as authorized or necessary to comply with workers’ compensation programs or similar laws.
Information may be disclosed for certain specialized governmental functions when authorized by law.
We will disclose information when federal or state law requires us to do so.
We will not use or disclose your Protected Health Information for marketing purposes when HIPAA requires your written authorization unless you provide such authorization.
Certain treatment-related or health-related communications may not constitute marketing under HIPAA.
TLC Dentistry does not sell patient Protected Health Information.
Where HIPAA would treat a transaction as a sale of PHI, we will obtain authorization when required.
We may use or disclose health information for research only when permitted by applicable law.
Depending upon the circumstances, research use may require:
TLC Dentistry does not routinely use identifiable patient information for research.
Some substance-use-disorder records receive additional protection under federal law, including 42 CFR Part 2.
To the extent TLC Dentistry creates or maintains records protected by Part 2, those records will be handled in accordance with applicable federal requirements.
Information protected by Part 2 generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against a patient based on the content of those records except as specifically permitted by federal law.
Certain information may receive additional protection under federal or Oregon law.
Depending upon the circumstances, this may include:
We will comply with laws imposing greater privacy protections when those laws apply.
Uses or disclosures not otherwise permitted by this Notice or applicable law generally require your written authorization.
If you provide authorization, you may revoke the authorization in writing at any time.
Revocation generally applies to future uses and disclosures and does not affect actions already taken in reliance upon your authorization.
TLC Dentistry is required to:
We will not use or disclose your information other than as permitted by law, as described in this Notice, or as authorized by you.
Ordinary email and SMS text messages may involve privacy and security risks.
TLC Dentistry will use reasonable safeguards and comply with applicable privacy and security requirements when communicating electronically.
Patients should avoid sending highly sensitive information through ordinary email or SMS unless specifically instructed to do so.
You may request a reasonable alternative method of communication.
We may change this Notice and our privacy practices as permitted by law.
Changes may apply to all health information maintained by TLC Dentistry, including information received or created before a revision.
When the Notice is materially revised, the current Notice will be made available:
If you have questions about this Notice, wish to exercise a privacy right, or wish to make a privacy complaint, contact:
Privacy Officer
TLC Dentistry
Andrew K. Phan, DMD
6919 SE 82nd Ave, Suite 103
Portland, OR 97266
Phone: 503-774-3546
Email: tlcdentistry.or@gmail.com
Website: tlcdentistrypdx.com
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.
TLC Dentistry will not retaliate against you for filing a complaint.
This Notice is effective September 23, 2026.