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Privacy of your personal information is an important part of our office providing you with quality dental care. We understand the importance of protecting your personal information. We are committed to collecting, using and disclosing your personal information responsibly. We also try to be as open and transparent as possible about the way we handle your personal information. It is important to us to provide this service to our patients. Our Privacy Information Officer is Dr. Timothy Lee and can be reached at: 2-117 Queen Street South Dr. Timothy Lee will attempt to answer any questions or concerns that you might have. If you do have a concern and/or wish to make a complaint to us about our privacy practices, including asking questions about the contents of your charts or records, you must make your request in writing. Please send it to our office’s Privacy Information Officer by surface mail, fax or e-mail. Our Privacy Information Officer will promptly acknowledge receipt of your complaint in writing, and will ensure that it is investigated thoroughly. You will be provided with a formal decision in writing, and the reason for the decision. Our privacy policies and procedures comply with federal legislation called the Personal Information Protection and Electronic Documents Act (PIPEDA). This very complex law does provide for some exceptions to the privacy principles that are too detailed to outline here. Our Privacy Code sets out this dental office’s commitment to protecting your private health and personal information. It is available on request by asking any of our office staff. Please be assured that every staff person in our office is committed to ensuring that you receive the best quality dental care. The Doctors and Staff
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| Privacy Act • Health Information and Privacy in Our Office • Dental Insurance 117 Queen Street South Unit 2 Mississauga ON L5M 6B5 • 905 567 8899 • smile@streetsvilledental.com |