Privacy Practice in Jacksonville, FL

Your Information. Your Rights. Our Responsibilities.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Your Rights

You have the right to:

Your Choices

You have some choices in the way that we use and share information as we:

Our Uses and Disclosures

We may use and share your information as we:

Your Information | Your Rights

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.
  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.
  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

Your Information | Your Choice

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

  • Marketing purposes
  • Sale of your information
  • Most sharing of psychotherapy notes
  • We may contact you for fundraising efforts, but you can tell us not to contact you again.

About Using Or Sharing Information

Our Uses and Disclosures

How do we typically use or share your health information? We typically use or share your health information in the following ways.

Treat you We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition. Run our organization We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services. Bill for your services We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services.

Treat you We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition. Run our organization We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services. Bill for your services We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services.

Our Responsibilities

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

EFFECTIVE DATE: 6/11/2019

This Notice of Privacy Practices applies to the following organizations.

Get To Know Your Doctor

Fred Tepedino, DMD

Specializes in Implant Dentistry

Dr. Fred Tepedino comes from a long line of dentists spanning four generations. He received his Doctorate in Dental Medicine from Nova Southeastern University and graduated with Honors in Periodontology. Always furthering his education and abilities, Dr. Tepedino continued his surgical training to achieve a Fellowship with The International Dental Implant Association and training in Advanced Alveolar Reconstruction. Taking the time to listen to his patients and hear their perspective on their oral health and dental needs, Dr. Tepedino establishes trust and rapport with them. Ever a perfectionist, Dr. Tepedino provides a high level of care and skill that truly set his practice apart.

Dr. Patel

Specializes in General Dentistry

Dr. Patel was born and raised in Jacksonville, FL. He got his dental degree in 2009 from The University of Florida and completed a residency in General Dentistry at the V.A Hospital in 2010. He completed comprehensive training in Implant dentistry at Augusta, Georgia in 2018 and holds accreditation with the American Academy of Implant Dentistry. He is married to his lovely wife Urmi. They have two children together Armaan and Nyra. Dr. Patel enjoys sports, music, and spending time with family.

Dr. Patel has experience treating patients of all ages. He can perform many different procedures from routine to specialty care. He understands going to the dentist can be filled with a lot of anxiety and stress. He strives to create an environment that is free of judgment and is understanding of each individual’s needs. He and his team will always take time to answer questions and go over all options. He looks forward to meeting you and helping with your dental care in anyway he can.