Effective Date: 01/13/2022I) Introduction
- Email: firstname.lastname@example.org
- Phone: (646) 933-5677
II) Information We Collect
The information we collect from you may be personally identifiable information (“Personal Information”), protected health information (“Health Information”) and non-personally identifiable information (“Non-Personal Information”).
III) Personal Information
We collect Personal Information you provide to us in connection with requests for materials through our website, requests for, and the provision of, services, purchases you make on our website, and subscriptions to receive information from Floss Bar.
The Personal Information we may collect from you includes, but is not limited to:
- Your name.
- Any medical information relevant to your clinical visits.
- Your contact information, such as your phone or email.
- Customer service phone calls.
- Survey responses to the extent you include Personal Information.
IV) Health Information
We are required by law to maintain the privacy of your Health Information. Any Health Information will be handled in full accordance with Health Insurance Portability and Accountability Act (“HIPAA”) and General Data Protection Regulation (“GDPR”) compliance standards, so we use and disclose Health Information about you for treatment, payment and maintaining our operations.
We may use or disclose your Health Information to a healthcare provider treating you. We may use and disclose your Health Information to obtain payment for services we provide to you. We use health data for purposes related to providing medical care and advice, as well as for insurance and health benefits administration purposes.
We must disclose your Health Information to you, as described in the Patient Rights section of this Policy. 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 provide consent for us to do so.
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 person’s involvement in your healthcare.V) Non-Personal Information
We may automatically gather certain Non-Personal Information for every visitor to our website via cookies. We may collect and store this information on an individual basis and in the aggregate. We may also collect both user-specific and aggregate information on what pages visitors access. Non–Personal Information we collect may include:
- IP address of the computer you use to access our website.
- The data and time you access our website.
- The website address, if any that linked you to our website.
- Search engine search terms and advertising clicks/actions.
- Weblogs and other clickstream data.
VI) Communications You Initiate with Us
If you contact us in person, by phone, email, social media, or by any other means, we may keep a record of your contact information and correspondence for later reference to help improve our services. When we send you emails, we may track whether you open them to figure out how to deliver more helpful content. We may send emails or regular mail to you in connection with your transaction or business relationship with us. We may also send email to you concerning special offers, promotions, appointment reminders. If you do not wish to receive promotional mailings, you may be removed from our mail lists through the use of an opt-out link that can be found in those messages.
We may use Personal Information internally to offer you goods and services we believe may be of interest. We may use Personal Information to contact you to inquire or survey about your experience at the location(s) you visited and the prospect of future services or improvements needed.
We may utilize one or more third-party service providers to send email or other communications to you on our behalf, including patient satisfaction surveys. These service providers are prohibited from using your email address or other contact information for any purpose other than to send communications on our behalf.
VII) Third Parties and Service Providers
Floss Bar will at times contract with other companies and individuals to perform functions or services on our behalf such as website hosting, data analysis, payment processing, order fulfillment, information technology and related infrastructure provision, customer service, email delivery, auditing and other services. These third parties may have access to Information needed to perform their functions but are restricted from using Personal Information for purposes other than providing services for us or to us.
Floss Bar is responsible for ensuring that our agents, service providers and other third parties to whom we disclose your information to in order to process the information in a manner consistent with HIPAA, and GDPR principles. Floss Bar ensures that all third parties and service providers that receive, store or otherwise engage with your Personal Information and Health Information are HIPPA and GDPR compliant.
Floss Bar does not sell, rent, or distribute personal data to non-agent third parties or permit its usage for reasons other than those for which it was originally provided. If this practice should change in the future, we will update this Policy to alert individuals and provide additional opt-in or opt-out resources as appropriate.
VIII) 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 law enforcement, counterintelligence, and other national security activities. We may disclose to a correctional institution or law enforcement official having lawful custody of the Health Information of an inmate or patient under certain other similar circumstances.IX) Jurisdiction
In the event of any dispute or claim relating to this Policy, you agree to resolution of such dispute in the State or Federal courts located in New York, in accordance with New York law.X) Patient Rights
Access. You have the right to look at or get copies of your 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 do so in a practical manner. We may charge a fee for producing dental records and X-rays, as allowed by law.
Disclosure Accounting. You have the right to receive a list of instances 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. 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.
Restrictions. 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). When you pay in full outside of your insurance plan for services you may request that we restrict this information and not disclose it to your healthcare plan or insurer.
Breach Notification. We will provide you with notification of a breach of unsecured protected health information, as required by law.XI) Use By Minors
Our website and services are not intended for children under the age of 18 without parental consent. If you are under 18 years of age, we must obtain valid and verifiable consent by your parent or legal guardian to this Policy before you can use or access our websites or services, and your subsequent use of, and access to, our website and services must be done under the supervision of your parent or legal guardian.
XII) Our Business Transfers
We reserve the right to disclose and transfer all Personal Information to a successor in interest of Floss Bar in connection with a merger, consolidation, restructuring, or change of control, the sale of substantially all of our interests and/or assets, or another organizational change (including during the course of any due diligence process), provided that the successor entity agrees to be bound by the terms of this Policy.
XIII) Policy Changes
We reserve the right to amend this Policy at our discretion and at any time. When we make changes to the Policy, we will post the update on our website and revise the Policy’s effective date. Your continued use of our website and services following the posting of changes constitutes your acceptance of said changes.