A. Garrett Gouldin, DDS, MS, PC
Periodontics & Dental Implants
103 West Broad Street, Suite 601, Falls Church, VA 22046
Tel 703.534.1766   Fax 703.534.1979
  • Patient Information
    • Welcome
    • What is a Periodontist?
    • Diplomate of the American Board of Periodontology
    • Scheduling
    • First Visit
    • Financial Policy
    • Insurance
    • Privacy Policy
    • Frequently Asked Questions
    • Patient Testimonials
  • Meet and Contact Us
    • Meet Dr. Gouldin
    • Meet Our Staff
    • Office Tour
    • Current Featured Artist
    • Past Featured Artists
    • Contact Our Office
    • Driving Directions / Parking
  • Periodontal Disease
    • Introduction
    • About Periodontal Disease
    • Preventing Gum Disease
    • Risk Factors
    • Oral Pathology
  • Non-Surgical Periodontal Procedures
    • Anesthesia Options
    • Scaling and Root Planing
    • Antimicrobials, Antiseptics and Antibiotics
    • Periostat
    • Local Delivery Antibiotics
    • Occlusal (Bite) Therapy
    • Oral Home Care
    • Supportive Periodontal Therapy
  • Surgical Periodontal Procedures
    • LANAP Laser Therapy
    • Osseous Surgery
    • Guided Tissue Regeneration and Bone Grafting
    • Functional Crown Lengthening
  • Cosmetic Periodontal Surgery
    • Esthetic Crown Lengthening
    • Soft Tissue Grafting
    • Soft Tissue Ridge Augmentation
  • Dental Implants
    • What are Dental Implants?
    • Single or Multiple Tooth Replacement
    • Immediate Restoration of Dental Implants
    • Overdentures
    • Socket Preservation
    • Hard Tissue Ridge Augmentation
    • Sinus Augmentation
  • Online Forms
    • Patient Registration
  • Dental Technology
    • In Office 3D Imaging
    • Digital Radiography
    • Platelet Rich Plasma
  • Referring Doctors
    • Referral Form
    • Upcoming Lectures
    • Past Lectures
    • AAP Guidelines for Periodontal Treatment
    • Links of Interest

Patient Information

  • Welcome
  • What is a Periodontist?
  • Diplomate of the American Board of Periodontology
  • Scheduling
  • First Visit
  • Financial Policy
  • Insurance
  • Privacy Policy
  • Frequently Asked Questions
  • Patient Testimonials

Privacy Policy

STATEMENT OF PRIVACY PRACTICES

Our office is dedicated to protect the privacy rights of our patients and the confidential information entrusted to us. The commitment of each employee to ensure that your health information is never compromised is a principle concept of our practice. We may, from time to time, amend our privacy policies and practices but will always inform you of any changes that might affect your rights.

Protecting Your Personal Healthcare Information

We use and disclose the information we collect from you only as allowed by the Health Insurance Portability and Accountability Act and the state of Virginia. This includes issues relating to your treatment, payment and dental care operations. Your personal health information will never be otherwise given to anyone – even family members – without your written consent. You, of course, may give written authorization for us to disclose your information to anyone you chose, for any purpose.

Our office and electronic systems are secure from unauthorized access and our employees are trained to make certain that the confidentiality of your records is always protected. Our privacy policy and practices apply to all former, current, and future patients, so you can be confident that your protected health information will never be improperly disclosed or released.

Collecting Protected Health Information

We will only request personal information needed to provide our standard of quality dental care, implement payment activities, conduct normal dental practice operations, and comply with the law. This may include your name, address, telephone number(s), Social Security Number, employment data, medical history, health records, etc. While most of the information will be collected from you, we may obtain information from third parties if it is deemed necessary. Regardless of the source, your personal information will always be protected to the full extent of the law.

Disclosure of your Protected Health Information

As stated above, we may disclose information as required by law. We are obligated to provide information to law enforcement and governmental officials under certain circumstances. We will not use your information for marketing purposes without your written consent.

We may use and/or disclose your health information to communicate reminders about your appointments including voicemail messages, answering machines, and postcards.

Patient Rights

You have a right to request copies of your healthcare information; to request copies of a variety of formats; and to request a list of instances in which we, or our business associates, have disclosed your protected information for uses other than stated above. All such requests must be in writing. We may charge for your copies in an amount allowed by law. If you believe your rights have been violated, we urge you to notify us immediately.

A. Garrett Gouldin, DDS, MS, PC  |  103 West Broad Street, Suite 601  |  Falls Church, VA 22046  |  Tel 703.534.1766  |  Fax 703.534.1979

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