HIPAA and Privacy
Right to Request Confidential Communications
You may request alternative communication methods or locations.
Right to Amend
You may request an amendment to your records. If denied, we will provide a written explanation.
Right to Notification of a Breach
You will be notified of any breach of your unsecured protected health information as required by law.
Right to a Paper Copy
You may request a paper copy of this Notice at any time.
QUESTIONS OR COMPLAINTS
If you have questions, concerns, or believe your privacy rights have been violated, you may contact us using the information below. You may also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate for filing a complaint.
SMS DISCLOSURE
By providing a telephone number and submitting this form, you consent to receive SMS text messages from Baumwoll Orthodontics about our services. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out of further messaging and HELP for assistance or call (973) 989-5100.
Please see our Privacy Policy.
PRIVACY OFFICIAL CONTACT INFORMATION
Privacy Official Name: Jenna or Natalie
Telephone: (973) 989-5100
Fax: (973) 989-5104
Address: 390 Route 10 West, Randolph NJ, 07869
Email: office@baumwollortho.com
We may disclose information to approved researchers with appropriate privacy safeguards.
Coroners, Medical Examiners, Funeral Directors
We may disclose information as necessary for identification, determining cause of death, or fulfilling their duties.
Fundraising
We may contact you regarding fundraising activities. You may opt out at any time.
Substance Use Disorder Treatment Information
(42 CFR Part 2)
We will handle any Part 2 Program records in accordance with federal confidentiality rules and your specific consent.
OTHER USES AND DISCLOSURES
Your written authorization is required for:
Psychotherapy notes
• Marketing uses of PHI
• Sale of PHI
• Any other use or disclosure not described in this Notice
You may revoke authorization at any time in writing.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
Right of Access
You may inspect or obtain copies of your health information, with limited exceptions. Requests must be in writing. Reasonable, cost-based fees may apply.
Right to Request an Accounting of Disclosures
You may request a list of certain disclosures made in the past six years.
Right to Request Restrictions
You may request restrictions on how we use or disclose your information. We are not required to agree, except when disclosure is to a health plan for a service paid in full out-of-pocket. We may disclose your health information to family, friends, or others involved in your care or payment for your care, as identified by you.
Disaster Relief
We may disclose information to assist in disaster relief efforts.
Required by Law
We will disclose information when required by federal, state, or local law.
Public Health Activities
We may disclose information to:
- Prevent or control disease, injury, or disability
- Report child abuse or neglect
- Report adverse reactions to medications or product issues
- Notify individuals of recalls
- Notify individuals exposed to disease
- Report suspected abuse, neglect, or domestic violence
National Security and Law Enforcement
We may disclose information to military authorities, authorized federal officials, correctional institutions, or law enforcement as permitted by law.
Secretary of HHS
We must disclose information when required to investigate HIPAA compliance.
Worker's Compensation
We may disclose information as authorized to comply with worker's compensation laws.
Health Oversight Activities
We may disclose information for audits, investigations, inspections, and licensure activities.
Judicial and Administrative Proceedings
We may disclose information in response to a court or administrative order, subpoena, or other lawful process.
Research
Baumwoll Orthodontics
390 Rt 10, Randolph, NJ | (973) 989-5100 | office@baumwollortho.com | www.baumwollortho.com
NOTICE OF PRIVACY PRACTICES
Effective Date: February 16, 2026
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.