Latched Beginnings Dr. Kacie M. Culotta, DDS Austin, Texas
Effective Date: March 2026
THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU AND YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Commitment to Your Privacy
At Latched Beginnings, we understand that the health information we collect about you and your child is personal. Protecting that information is something we take seriously — not just because the law requires it, but because trust is at the heart of everything we do. We are required by law to maintain the privacy of your Protected Health Information (PHI), provide you with this Notice of our legal duties and privacy practices, and follow the terms of the Notice currently in effect.
This Notice applies to all records related to your care at Latched Beginnings, whether created by Dr. Kacie M. Culotta, a member of our clinical team, or received from other healthcare providers involved in your child’s care.
How We May Use and Disclose Your Protected Health Information
The following describes the ways we may use and disclose PHI in the course of providing care to you and your family. For each category, we have included examples relevant to our practice to help illustrate what these uses look like in a real-world setting.
For Treatment
We may use and disclose your child’s health information to provide, coordinate, and manage care. This includes sharing relevant information with other healthcare providers who are part of your child’s care team.
For example, if your infant is referred to Latched Beginnings by a lactation consultant for a tongue-tie evaluation, we may share the results of Dr. Culotta’s assessment and any treatment plan — including details about a CO2 laser release, post-operative care instructions, or recommended bodywork — with that referring provider to ensure coordinated follow-up. Similarly, we may communicate with your child’s pediatrician, pediatric chiropractor, or speech-language pathologist when collaboration supports your baby’s healing and feeding progress.
For Payment
We may use and disclose your child’s health information to obtain payment for the services we provide. This includes submitting claims or documentation to your health insurance plan or providing you with the information you need to seek reimbursement on your own.
For example, if you request a superbill or itemized statement for a tongue-tie consultation or laser release procedure so you can submit it to your insurance for potential out-of-network reimbursement, we would include relevant diagnostic and procedure information on that document.
For Healthcare Operations
We may use and disclose your health information for our internal operations. These are activities necessary to run our practice and ensure that all patients receive high-quality care.
For example, we may use your information for quality improvement reviews, staff training on post-operative care protocols, or internal audits to ensure our records and procedures meet professional and legal standards. We may also use information in the course of evaluating clinical outcomes to continually improve the care we provide.
Other Situations in Which We May Use or Disclose Your PHI Without Your Authorization
In addition to treatment, payment, and healthcare operations, the law permits or requires us to use or disclose your health information without your written authorization in certain circumstances, including the following.
As Required by Law. We will disclose your health information when required to do so by federal, state, or local law.
Public Health Activities. We may disclose health information to public health authorities for purposes such as preventing or controlling disease, reporting births or deaths, or reporting reactions to medications or problems with medical devices or products.
Abuse, Neglect, or Domestic Violence. If we reasonably believe a patient is a victim of abuse, neglect, or domestic violence, we may disclose health information to the appropriate government authority as required or permitted by law.
Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law, such as audits, inspections, investigations, or licensure actions.
Judicial and Administrative Proceedings. We may disclose health information in response to a court order or, under certain conditions, in response to a subpoena, discovery request, or other lawful process.
Law Enforcement. We may disclose health information to law enforcement officials under limited circumstances, such as in response to a court order or warrant, to identify or locate a suspect, or to report certain types of wounds or injuries.
Coroners, Medical Examiners, and Funeral Directors. We may disclose health information to a coroner, medical examiner, or funeral director as necessary for them to carry out their duties.
Organ and Tissue Donation. If applicable, we may disclose health information to organizations involved in organ, eye, or tissue procurement, banking, or transplantation.
Research. Under certain conditions, we may use or disclose health information for approved research purposes, subject to oversight and safeguards required by law.
Serious Threat to Health or Safety. We may use and disclose health information when necessary to prevent a serious and imminent threat to the health or safety of a person or the public.
Workers’ Compensation. We may disclose health information as authorized by and necessary to comply with workers’ compensation laws or similar programs.
Military, Veterans, and National Security. If applicable, we may disclose health information for military, veterans’ affairs, national security, intelligence, or protective services activities as required by law.
Inmates and Individuals in Custody. If a patient is an inmate of a correctional institution or in the custody of a law enforcement official, we may disclose health information necessary for the institution to provide healthcare, protect the health and safety of the individual or others, or for the safety and security of the institution.
Appointment Reminders and Health-Related Communications. We may use your health information to contact you with appointment reminders, follow-up care instructions, or information about treatment alternatives or health-related benefits and services that may be of interest to you. These communications may be sent by phone call, text message, email, or mail. If you prefer not to receive certain communications, please let us know and we will do our best to accommodate your request.
Business Associates. We may disclose your health information to our business associates — companies that perform services on our behalf, such as our patient scheduling system, text messaging service provider, or billing support — provided they agree in writing to protect your information in compliance with HIPAA.
Uses and Disclosures That Require Your Written Authorization
For uses and disclosures not described in this Notice, we will ask for your written authorization before using or disclosing your health information. The following are examples of uses that require your authorization.
Marketing. We will not use your health information for marketing purposes without your written authorization, except in limited circumstances permitted by law (such as face-to-face communications or promotional gifts of nominal value).
Sale of PHI. We will never sell your health information without your written authorization.
Psychotherapy Notes. If applicable, we will not use or disclose psychotherapy notes without your written authorization, except in limited circumstances permitted by law.
If you provide us with written authorization to use or disclose your health information, you may revoke that authorization in writing at any time. Your revocation will not affect any uses or disclosures that occurred before we received your revocation.
Your Rights Regarding Your Health Information
You have the following rights with respect to the health information we maintain about you and your child. To exercise any of these rights, please contact our Privacy Officer using the contact information provided at the end of this Notice.
Right to Access Your Health Information
You have the right to inspect and obtain a copy of your health information that we maintain in our records, including medical and billing records. Your request must be submitted in writing. We may charge a reasonable, cost-based fee for providing copies. In certain limited circumstances, we may deny your request to access your records, and if we do, we will explain the reason and inform you of your right to have the denial reviewed.
Right to Request an Amendment
If you believe that health information we have about you or your child is incorrect or incomplete, you have the right to request that we amend the information. Your request must be submitted in writing and must include the reason you are requesting the amendment. We may deny your request under certain circumstances — for example, if the information was not created by our practice or if we determine the information is accurate and complete. If we deny your request, we will provide you with a written explanation.
Right to Request Restrictions
You have the right to request that we restrict certain uses and disclosures of your health information. For example, you may ask us not to share certain information with a particular provider involved in your child’s care. We are not required to agree to your request, but if we do agree, we will comply with the restriction except in emergency situations. However, we are required to agree to a restriction if you request that we not disclose information to your health plan for a service you paid for entirely out of pocket.
Right to an Accounting of Disclosures
You have the right to request a list (accounting) of certain disclosures we have made of your health information. This accounting does not include disclosures made for treatment, payment, or healthcare operations, or disclosures you authorized in writing, among other exceptions. Your request must be submitted in writing and must specify the time period you are requesting (which may not exceed six years prior to the date of your request). The first accounting in any 12-month period is free; we may charge a reasonable fee for additional requests.
Right to Request Confidential Communications
You have the right to request that we communicate with you about your health information in a specific way or at a specific location. For example, you may ask that we call you only at a particular phone number or send correspondence to a specific address. We will accommodate reasonable requests. Your request must be submitted in writing.
Right to Receive a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice at any time, even if you previously agreed to receive it electronically. To obtain a paper copy, please contact our Privacy Officer or request one during your next visit.
Right to Be Notified of a Breach
You have the right to be notified if there is a breach of your unsecured health information. If a breach occurs, we will notify you as required by law.
Our Legal Duties
We are required by law to maintain the privacy and security of your Protected Health Information. We are required to provide you with this Notice of our legal duties and privacy practices with respect to your health information. We are required to abide by the terms of this Notice currently in effect. We will not use or disclose your health information without your authorization, except as described in this Notice.
We reserve the right to change the terms of this Notice and to make new provisions effective for all PHI we maintain, including information created or received before the changes were made. If we make a material change to this Notice, we will make the revised Notice available on our website at latchedbeginnings.com and will have copies available at our office.
How to File a Complaint
If you believe your privacy rights have been violated, you have the right to file a complaint. You will not be penalized or retaliated against for filing a complaint.
To file a complaint with our practice, please contact:
Dr. Kacie M. Culotta, DDS — Privacy Officer Latched Beginnings Austin, Texas Phone: (512) 814-7480 Website: latchedbeginnings.com
To file a complaint with the U.S. Department of Health and Human Services, you may contact:
Office for Civil Rights U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 Phone: 1-877-696-6775 Website: hhs.gov/ocr/privacy/hipaa/complaints
Contact Information
If you have any questions about this Notice or about our privacy practices, please contact our Privacy Officer:
Dr. Kacie M. Culotta, DDS Privacy Officer Latched Beginnings Austin, Texas Phone: (512) 814-7480 Website: latchedbeginnings.com
This Notice is effective as of March 2026 and applies to all Protected Health Information maintained by Latched Beginnings. We encourage you to read it carefully. If you have any questions, we are always here to help.
