897305630376469
2364 Open hands 2 Web.jpg

Notice of Privacy Policy


The federal government requires all dental offices to provide to our patients a copy of our policy regarding your privacy and information security. This Notice is available in our office and you may request a copy. This privacy policy may be changed or revised at any time and within the requirements of the Law. Before significant changes are made to our Privacy Policy we will change the Notice and make copies available upon request. When revised, we will make the revision available and post same in our office. You may make a request for a copy at any time. For more information concerning our Privacy Policy or to request more copies of same, please contact our office by telephone at (386) 574-5201 or email at DrZ@Zerivitz.com

How we use your personal Health Information:

Your personal health information is confidential and not disclosed, except in certain instances. These can include:

  • For treatment purposes, we may contact other doctors, medical and dental offices, dental laboratories and others involved in your care. We may share information with their staff along with our staff and doctors in order to provide comprehensive and safe care to you. We may share x-rays, clinical data, requests for treatment, clinical results, treatment details, diagnoses and any other information that our doctor(s) deem necessary to share on your behalf.

  • Communications with other health-care providers, insurers, laboratories, etc. will be done over secure channels.

  • For training and care assessment and improvement purposes. These can also include sharing information about your treatment, reviewing all communications with our office including electronic communications and recorded phone conversations whether initiated by you or by us, sharing with our consultants, and any others deemed important to provide your dental care.

  • We may share your personal health information with insurance companies and health care financing companies as needed to help you receive your benefits and make payment more affordable to you.

Who else can receive your personal health information?

  • With your authorization, we can discuss your care, your treatment plan, and diagnosis with your family, a guardian, or friends. Otherwise, you are the only person to whom we can disclose your personal health information.

  • You may revoke or withdraw your permission at any time.

  • In an emergency (or a situation where we cannot contact you), we will use our professional judgment in case it becomes necessary to involve other persons in decisions related to your care. We will always consult with you, if at all possible, before communicating with other persons about you, your care, or your health.

Electronic and mail communications, including marketing and other information

  • Our office communicates with patients in many ways. These include text messaging of appointment reminders, emails to confirm appointments, voice-mails left on your telephone, mailings for appointment reminders, mailed statements of your account, emailed newsletters and special offers, along with other marketing materials. You may call, email, or opt-out of any of these methods of communications.

  • We may use the services of third party companies to send information to you. We remain careful to select companies who will maintain the security of you personal health information or other related demographic information.

  • Many websites use “cookie” technology to gather additional information about the people who visit a website, respond to ads, or otherwise communicate with our office. We use the information gathered to provide a better user experience and to help you receive the dental care that you seek.

  • Some cookies help you to receive the functions of our website. These (persistent) cookies may remain on your computer. They may be blocked or erased by you.

  • We collect user information when you respond to internet based advertising. This information does not contain any personal health information, unless you share it with us. We may respond to your inquiries or comments left on various social media and make every attempt to avoid making any references which may identify you. Note that communicating with us by social media is, by definition, a non-secure, non-private method of communication.

  • While using our website or marketing ads, we may collect your log data, including IP address, device identifiers, browser and type, statistics about your visit to our site like time and date, etc. This information may be shared with our third-party vendors to improve our marketing and your user experience.

  • We may use third party analysis of your visits to our site or to create a response to your ads. We use sites like Google Analytics and Lead Owl to gather non-health related data. Third-party vendors have their own privacy policies and we are not responsible for their practices.

There are certain cases where we are required, by law, to share your data

  • If requested by the police, the court system, the military, or other governmental agencies, we may disclose your personal health information. If served with a court subpoena we will disclose your information.

  • If we have reason to suspect that you, or a family member are a victim of domestic violence, domestic abuse, or other crimes of a similar nature, we may disclose and report these suspicions to the proper authorities.

What are your rights?

  • With certain exceptions, you have the right to view your personal health information that we hold, and to make corrections as needed. You may request copies of your data, although we may charge a reasonable fee for reproducing dental records and x-rays (Florida statutes).

  • If you suspect that we may have disclosed your health information for purposes beyond those listed in this Privacy Notice, you may request a list of those potential disclosures for six years, in arrears. You may receive this accounting once each year. Additional requests will incur a bookkeeping fee.

  • You may request further restrictions on the disclosure of your personal health information or our use thereof. We will do our best to honor your requests.

  • In the event that you need us to communicate with you in manners beyond the traditional, you may request, in writing, exactly how you prefer us to reach you. This may include phone, mail, or other methods. We will do our best to honor your requests.

  • In the unlikely event of a breach of secured personal health information, we will notify you , as required by law.

  • You have the right to receive this Privacy Notice in writing, upon request.

  • If you are concerned that your privacy may have been breached or disclosed in a manner that is not consistent with our policy, you may submit your concerns in writing to: Privacy Compliance Officer, c/o Michael A. Zerivitz DDS PA; 916 Deltona Boulevard, Deltona, FL 32725

  • As an alternative method of expressing a concern you may also contact the US Dept of Health and Human Services.










Revised November 2018