diff --git a/frontend/components/settings/delete-account-dialog.tsx b/frontend/components/settings/delete-account-dialog.tsx
new file mode 100644
index 0000000..f98ab46
--- /dev/null
+++ b/frontend/components/settings/delete-account-dialog.tsx
@@ -0,0 +1,105 @@
+"use client";
+
+import { useState } from "react";
+import { TriangleAlert } from "lucide-react";
+import { useTranslation } from "react-i18next";
+
+import { Button } from "@/components/ui/button";
+import {
+  Dialog,
+  DialogClose,
+  DialogDescription,
+  DialogFooter,
+  DialogHeader,
+  DialogPanel,
+  DialogPopup,
+  DialogTitle,
+} from "@/components/ui/dialog";
+import { Input } from "@/components/ui/input";
+import { FieldLabel } from "@/components/settings/settings-parts";
+import { authClient } from "@/lib/auth-client";
+
+// Confirms (with the user's password) before permanently deleting the account
+// via Better Auth's deleteUser, then bounces to /login.
+export function DeleteAccountDialog({
+  open,
+  onOpenChange,
+}: {
+  open: boolean;
+  onOpenChange: (open: boolean) => void;
+}) {
+  const { t } = useTranslation();
+  const [password, setPassword] = useState("");
+  const [deleting, setDeleting] = useState(false);
+  const [error, setError] = useState<string | null>(null);
+
+  const reset = (next: boolean) => {
+    if (!next) {
+      setPassword("");
+      setError(null);
+      setDeleting(false);
+    }
+    onOpenChange(next);
+  };
+
+  const confirmDelete = async () => {
+    setDeleting(true);
+    setError(null);
+    const { error: err } = await authClient.deleteUser({ password });
+    if (err) {
+      setError(err.message ?? t("settings.profile.deleteDialog.failed"));
+      setDeleting(false);
+      return;
+    }
+    // Sessions are revoked server-side; send the user back to login.
+    window.location.href = "/login";
+  };
+
+  return (
+    <Dialog onOpenChange={reset} open={open}>
+      <DialogPopup className="sm:max-w-md">
+        <DialogHeader>
+          <DialogTitle className="flex items-center gap-2">
+            <TriangleAlert className="size-4 text-destructive" />
+            {t("settings.profile.deleteDialog.title")}
+          </DialogTitle>
+          <DialogDescription>
+            {t("settings.profile.deleteDialog.description")}
+          </DialogDescription>
+        </DialogHeader>
+        <DialogPanel className="flex flex-col gap-3">
+          <div className="space-y-1.5">
+            <FieldLabel required>
+              {t("settings.profile.deleteDialog.passwordLabel")}
+            </FieldLabel>
+            <Input
+              autoComplete="current-password"
+              onChange={(event) => setPassword(event.target.value)}
+              placeholder={t(
+                "settings.profile.deleteDialog.passwordPlaceholder",
+              )}
+              type="password"
+              value={password}
+            />
+          </div>
+          {error ? <p className="text-sm text-destructive">{error}</p> : null}
+        </DialogPanel>
+        <DialogFooter>
+          <DialogClose render={<Button type="button" variant="outline" />}>
+            {t("settings.profile.deleteDialog.cancel")}
+          </DialogClose>
+          <Button
+            disabled={deleting || password.length === 0}
+            onClick={confirmDelete}
+            type="button"
+            variant="destructive"
+          >
+            {deleting
+              ? t("settings.profile.deleteDialog.deleting")
+              : t("settings.profile.deleteDialog.confirm")}
+          </Button>
+        </DialogFooter>
+      </DialogPopup>
+    </Dialog>
+  );
+}
diff --git a/frontend/components/settings/settings-parts.tsx b/frontend/components/settings/settings-parts.tsx
index 5fced4d..c64f45c 100644
--- a/frontend/components/settings/settings-parts.tsx
+++ b/frontend/components/settings/settings-parts.tsx
@@ -1,7 +1,8 @@
 "use client";
 
 import type { ReactNode } from "react";
-import { Copy } from "lucide-react";
+import { useState } from "react";
+import { Check, Copy } from "lucide-react";
 import { useTranslation } from "react-i18next";
 
 import { cn } from "@/lib/utils";
@@ -52,10 +53,15 @@ export function ToggleRow({
   title,
   description,
   defaultChecked = false,
+  checked,
+  onCheckedChange,
 }: {
   title: string;
   description?: string;
   defaultChecked?: boolean;
+  /** Pass `checked` + `onCheckedChange` to make the switch controlled. */
+  checked?: boolean;
+  onCheckedChange?: (checked: boolean) => void;
 }) {
   return (
     <SettingsCard className="flex items-center justify-between gap-4 px-4 py-3.5">
@@ -65,7 +71,11 @@ export function ToggleRow({
           <p className="text-sm text-muted-foreground">{description}</p>
         ) : null}
       </div>
-      <Switch defaultChecked={defaultChecked} />
+      <Switch
+        checked={checked}
+        defaultChecked={checked === undefined ? defaultChecked : undefined}
+        onCheckedChange={onCheckedChange}
+      />
     </SettingsCard>
   );
 }
@@ -80,6 +90,16 @@ export function CopyField({
   value: string;
 }) {
   const { t } = useTranslation();
+  const [copied, setCopied] = useState(false);
+  const copy = async () => {
+    try {
+      await navigator.clipboard.writeText(value);
+      setCopied(true);
+      setTimeout(() => setCopied(false), 1500);
+    } catch {
+      // Clipboard unavailable (insecure context) — silently ignore.
+    }
+  };
   return (
     <div className="flex flex-col gap-2 sm:flex-row sm:items-center sm:justify-between">
       <div className="space-y-0.5">
@@ -94,10 +114,15 @@ export function CopyField({
         </span>
         <button
           className="flex items-center gap-1 rounded-full px-2.5 py-1 text-xs font-medium text-foreground transition-colors hover:bg-accent"
+          onClick={copy}
           type="button"
         >
-          <Copy className="size-3.5" />
-          {t("settings.copy")}
+          {copied ? (
+            <Check className="size-3.5" />
+          ) : (
+            <Copy className="size-3.5" />
+          )}
+          {copied ? t("settings.copied") : t("settings.copy")}
         </button>
       </div>
     </div>
diff --git a/frontend/components/settings/settings-preferences.tsx b/frontend/components/settings/settings-preferences.tsx
index 78e4a1e..14aa68a 100644
--- a/frontend/components/settings/settings-preferences.tsx
+++ b/frontend/components/settings/settings-preferences.tsx
@@ -1,11 +1,13 @@
 "use client";
 
+import { useEffect, useState } from "react";
 import { ChevronDown, Plus } from "lucide-react";
 import { useTranslation } from "react-i18next";
 
 import { Avatar, AvatarFallback } from "@/components/ui/avatar";
 import { Button } from "@/components/ui/button";
 import { Input } from "@/components/ui/input";
+import { DeleteAccountDialog } from "@/components/settings/delete-account-dialog";
 import {
   CopyField,
   FieldLabel,
@@ -13,8 +15,15 @@ import {
   SettingsSection,
   ToggleRow,
 } from "@/components/settings/settings-parts";
+import { authClient } from "@/lib/auth-client";
+import {
+  getSettings,
+  saveSettings,
+  type UserPreferences,
+} from "@/lib/settings";
+import { notify } from "@/lib/toast";
 
-// Keys into settings.profile.notif.* — these toggles are illustrative.
+// Keys into settings.profile.notif.* — each maps to a persisted preference.
 const patientNotifications = [
   { titleKey: "newLab", descKey: "newLabDesc" },
   { titleKey: "recordUpdated", descKey: "recordUpdatedDesc" },
@@ -24,8 +33,100 @@ const patientNotifications = [
   { titleKey: "visitScheduled", descKey: "visitScheduledDesc" },
 ] as const;
 
+const accountNotifications = [
+  { titleKey: "pendingApprovals", descKey: "pendingApprovalsDesc" },
+  { titleKey: "recordsShared", descKey: "recordsSharedDesc" },
+] as const;
+
+// All notification toggles default to on; profile extras default to empty.
+const DEFAULT_PREFS: UserPreferences = {
+  "notif.newLab": true,
+  "notif.recordUpdated": true,
+  "notif.approvalRequested": true,
+  "notif.changeApproved": true,
+  "notif.newMessage": true,
+  "notif.visitScheduled": true,
+  "notif.pendingApprovals": true,
+  "notif.recordsShared": true,
+  clinic: "",
+  contactEmail: "",
+};
+
 export function ProfilePanel() {
   const { t } = useTranslation();
+  const { data: session } = authClient.useSession();
+  const user = session?.user;
+
+  const [prefs, setPrefs] = useState<UserPreferences>(DEFAULT_PREFS);
+  const [baseline, setBaseline] = useState<UserPreferences>(DEFAULT_PREFS);
+  const [name, setName] = useState("");
+  const [baselineName, setBaselineName] = useState("");
+  const [saving, setSaving] = useState(false);
+  const [deleteOpen, setDeleteOpen] = useState(false);
+
+  useEffect(() => {
+    let cancelled = false;
+    getSettings()
+      .then((stored) => {
+        if (cancelled) return;
+        const merged = { ...DEFAULT_PREFS, ...stored };
+        setPrefs(merged);
+        setBaseline(merged);
+      })
+      .catch(() => {
+        // Keep the defaults; the page still works and Save will retry.
+      });
+    return () => {
+      cancelled = true;
+    };
+  }, []);
+
+  // Seed the display name from the session once it loads.
+  useEffect(() => {
+    if (user?.name) {
+      setName((prev) => prev || user.name);
+      setBaselineName((prev) => prev || user.name);
+    }
+  }, [user?.name]);
+
+  const setPref = (key: string, value: boolean | string) =>
+    setPrefs((prev) => ({ ...prev, [key]: value }));
+
+  const dirty =
+    name !== baselineName || JSON.stringify(prefs) !== JSON.stringify(baseline);
+
+  const save = async () => {
+    setSaving(true);
+    try {
+      const saved = await saveSettings(prefs);
+      const trimmed = name.trim();
+      if (trimmed && trimmed !== baselineName) {
+        const { error } = await authClient.updateUser({ name: trimmed });
+        if (error) throw new Error(error.message ?? "updateUser failed");
+        setName(trimmed);
+        setBaselineName(trimmed);
+      }
+      const merged = { ...DEFAULT_PREFS, ...saved };
+      setPrefs(merged);
+      setBaseline(merged);
+      notify.success(
+        t("settings.profile.savedTitle"),
+        t("settings.profile.savedBody"),
+      );
+    } catch {
+      notify.error(
+        t("settings.profile.saveFailedTitle"),
+        t("settings.profile.saveFailedBody"),
+      );
+    } finally {
+      setSaving(false);
+    }
+  };
+
+  const initial = (name || user?.name || "?").trim().charAt(0).toUpperCase();
+  const username =
+    (user as { username?: string | null } | undefined)?.username ?? null;
+
   return (
     <>
       <SettingsSection title={t("settings.profile.sectionTitle")}>
@@ -33,12 +134,12 @@ export function ProfilePanel() {
           <CopyField
             description={t("settings.profile.clinicianIdDescription")}
             label={t("settings.profile.clinicianIdLabel")}
-            value="62a5278f-91c6-4912-b711-ee1c9c2f0a73"
+            value={user?.id ?? "—"}
           />
           <CopyField
             description={t("settings.profile.handleDescription")}
             label={t("settings.profile.handleLabel")}
-            value="dr-khalid"
+            value={username ?? user?.email ?? "—"}
           />
 
           <div className="flex items-end gap-4">
@@ -46,7 +147,7 @@ export function ProfilePanel() {
               <FieldLabel>{t("settings.profile.avatar")}</FieldLabel>
               <Avatar className="size-10 rounded-xl">
                 <AvatarFallback className="rounded-xl bg-muted text-sm font-medium">
-                  K
+                  {initial}
                 </AvatarFallback>
               </Avatar>
             </div>
@@ -54,7 +155,10 @@ export function ProfilePanel() {
               <FieldLabel required>
                 {t("settings.profile.displayName")}
               </FieldLabel>
-              <Input defaultValue="Dr. Khalid" />
+              <Input
+                onChange={(event) => setName(event.target.value)}
+                value={name}
+              />
             </div>
           </div>
 
@@ -72,14 +176,22 @@ export function ProfilePanel() {
           <div className="grid gap-4 sm:grid-cols-2">
             <div className="space-y-1.5">
               <FieldLabel>{t("settings.profile.clinic")}</FieldLabel>
-              <Input placeholder={t("settings.profile.clinicPlaceholder")} />
+              <Input
+                onChange={(event) => setPref("clinic", event.target.value)}
+                placeholder={t("settings.profile.clinicPlaceholder")}
+                value={String(prefs.clinic ?? "")}
+              />
             </div>
             <div className="space-y-1.5">
               <FieldLabel required>
                 {t("settings.profile.contactEmail")}
               </FieldLabel>
               <Input
+                onChange={(event) =>
+                  setPref("contactEmail", event.target.value)
+                }
                 placeholder={t("settings.profile.contactEmailPlaceholder")}
+                value={String(prefs.contactEmail ?? "")}
               />
             </div>
           </div>
@@ -106,9 +218,12 @@ export function ProfilePanel() {
         <div className="space-y-3">
           {patientNotifications.map((item) => (
             <ToggleRow
-              defaultChecked
+              checked={Boolean(prefs[`notif.${item.titleKey}`])}
               description={t(`settings.profile.notif.${item.descKey}`)}
               key={item.titleKey}
+              onCheckedChange={(checked) =>
+                setPref(`notif.${item.titleKey}`, checked)
+              }
               title={t(`settings.profile.notif.${item.titleKey}`)}
             />
           ))}
@@ -120,19 +235,21 @@ export function ProfilePanel() {
         title={t("settings.profile.accountNotifications")}
       >
         <div className="space-y-3">
-          <ToggleRow
-            defaultChecked
-            description={t("settings.profile.notif.pendingApprovalsDesc")}
-            title={t("settings.profile.notif.pendingApprovals")}
-          />
-          <ToggleRow
-            defaultChecked
-            description={t("settings.profile.notif.recordsSharedDesc")}
-            title={t("settings.profile.notif.recordsShared")}
-          />
+          {accountNotifications.map((item) => (
+            <ToggleRow
+              checked={Boolean(prefs[`notif.${item.titleKey}`])}
+              description={t(`settings.profile.notif.${item.descKey}`)}
+              key={item.titleKey}
+              onCheckedChange={(checked) =>
+                setPref(`notif.${item.titleKey}`, checked)
+              }
+              title={t(`settings.profile.notif.${item.titleKey}`)}
+            />
+          ))}
         </div>
       </SettingsSection>
 
+      {/* Future features — intentionally not wired to persistence yet. */}
       <SettingsSection
         description={t("settings.profile.featuresDescription")}
         title={t("settings.profile.features")}
@@ -162,9 +279,28 @@ export function ProfilePanel() {
               {t("settings.profile.deleteAccountDescription")}
             </p>
           </div>
-          <Button variant="destructive">{t("settings.profile.delete")}</Button>
+          <Button onClick={() => setDeleteOpen(true)} variant="destructive">
+            {t("settings.profile.delete")}
+          </Button>
         </SettingsCard>
       </SettingsSection>
+
+      <DeleteAccountDialog onOpenChange={setDeleteOpen} open={deleteOpen} />
+
+      {dirty ? (
+        <div className="sticky bottom-4 z-10">
+          <div className="flex items-center justify-between gap-4 rounded-2xl border border-border bg-background/95 px-4 py-3 shadow-lg backdrop-blur">
+            <p className="text-sm text-muted-foreground">
+              {t("settings.profile.unsavedChanges")}
+            </p>
+            <Button disabled={saving} onClick={save} size="sm">
+              {saving
+                ? t("settings.profile.saving")
+                : t("settings.profile.saveChanges")}
+            </Button>
+          </div>
+        </div>
+      ) : null}
     </>
   );
 }
diff --git a/frontend/lib/i18n/locales/en/translation.json b/frontend/lib/i18n/locales/en/translation.json
index 43c5884..b917d3a 100644
--- a/frontend/lib/i18n/locales/en/translation.json
+++ b/frontend/lib/i18n/locales/en/translation.json
@@ -695,6 +695,7 @@
     },
     "empty": "Nothing here yet.",
     "copy": "Copy",
+    "copied": "Copied",
     "records": {
       "description": "How patient records are sourced, stored, and displayed"
     },
@@ -729,6 +730,23 @@
       "deleteAccount": "Delete account",
       "deleteAccountDescription": "Permanently delete your temetro account and any locally stored signing keys. This action cannot be undone.",
       "delete": "Delete",
+      "unsavedChanges": "You have unsaved changes",
+      "saveChanges": "Save changes",
+      "saving": "Saving…",
+      "savedTitle": "Settings saved",
+      "savedBody": "Your preferences are up to date.",
+      "saveFailedTitle": "Couldn't save settings",
+      "saveFailedBody": "Please try again.",
+      "deleteDialog": {
+        "title": "Delete your account?",
+        "description": "This permanently deletes your account, removes you from your clinics, and cannot be undone.",
+        "passwordLabel": "Confirm your password",
+        "passwordPlaceholder": "Your password",
+        "cancel": "Cancel",
+        "confirm": "Delete account",
+        "deleting": "Deleting…",
+        "failed": "Couldn't delete the account. Check your password and try again."
+      },
       "notif": {
         "newLab": "New lab result",
         "newLabDesc": "Sent when a new lab result is available on a patient's chart",
diff --git a/frontend/lib/settings.ts b/frontend/lib/settings.ts
new file mode 100644
index 0000000..9b670fe
--- /dev/null
+++ b/frontend/lib/settings.ts
@@ -0,0 +1,24 @@
+import { apiFetch } from "@/lib/api-client";
+
+// Per-user preferences persisted by the backend (`user_settings` table) as a
+// flat key → boolean/string map. Unknown keys are preserved, so features can
+// add settings without coordinating with this file.
+export type UserPreferences = Record<string, boolean | string>;
+
+export async function getSettings(): Promise<UserPreferences> {
+  const res = await apiFetch<{ preferences: UserPreferences }>("/api/settings");
+  return res.preferences ?? {};
+}
+
+export async function saveSettings(
+  preferences: UserPreferences,
+): Promise<UserPreferences> {
+  const res = await apiFetch<{ preferences: UserPreferences }>(
+    "/api/settings",
+    {
+      method: "PUT",
+      body: JSON.stringify({ preferences }),
+    },
+  );
+  return res.preferences ?? {};
+}