At our office, we pride ourselves on forming life-long, professional relationships with our patients!

We want you to be well-informed and have a clear understanding of both your rights, and responsibilities within the practice.

The following is intended to promote our mission, while fostering your dignity, autonomy, and involvement in your care.

You have the Right to...

Patient-Centered Care

• Receive comprehensive, considerate, quality dental care that respects your culture, beliefs, preferences, and values
• Be treated with courtesy, respect, and the highest professional, ethical, and moral conduct by our team
• Schedule appointments and receive care in a timely manner

Comfort and Safety

• A safe, clean environment that is compliant with all infection-control standards
• A smoke-free environment
• Be comfortable during and after your dental procedure and/or have a family member, friend, or other individual present with you for emotional support
• Receive reasonable arrangements

Privacy and Confidentiality

• Privacy of your health information and dental record
• Privacy in discussions, examinations, and treatment

Participate in Treatment

• Know the names, education, and training of your providers
• Be informed about your diagnosis, prognosis, treatment options, risks, benefits, and alternatives
• Receive a fee estimate for all recommended treatment and understand how you will be expected to pay
• Request an itemized bill, examine it, and receive an explanation of it, regardless of the source of payment for services rendered
• Seek a second opinion any time you would like one and receive all digital x-rays at no cost
• Be informed about continuing health needs
• Consent or refuse treatment and understand any associated consequences

You have a Responsibility to...

General Considerations

• Provide honest and complete information and report all changes in medication, insurance, and contact information promptly
• Provide feedback about services and policies so we can continue to serve you best
• Let us know your needs and preferences to make your experience as comfortable and easy as possible

Maintaining Appointments

• Keep scheduled appointments— Repeated late, missed, or cancelled appointments impact our ability to provide quality care and will result in your dismissal from the practice
• Provide at least 48 hours notice for rescheduling to allow other patients the reserved time block and prevent a $75 late fee for each hour scheduled from being billed to your account — Extenuating circumstances will always be considered
• Be timely for appointments— Failing to show up, arriving more than 15 minutes late, or minors (under the age of 18) without a legal guardian present will result in a $75 late fee for each our scheduled
• Confirm appointment— Unconfirmed appointments will be cancelled 48 hours before the scheduled visit once multiple attempts to confirm a visit have gone unanswered

Financial Policy

• Pay for services by the time they are rendered— A monthly service charge is applied to all unpaid balances on accounts not paid in full within 90 days of the treatment date
• Pay any outstanding balance for yourself or dependents that is not fully covered by insurance — We will always maximize your insurance benefits first
• Pay a service charge of $25 for any returned check
• Contact our office promptly to communicate any financial hardships or concerns so we may assist you in the management of your account

Treatment Considerations

• Participate fully in the decisions related to your care
• Ask questions when you do not understand information or instructions
• Follow post-operative and prevention tips at home

Notice of Privacy Practices

We partner with experts in cyber security and HIPAA-compliance to promote the highest level of protection for all medical records and personal health information. Each year we work with a cyber security consultant to conduct a risk analysis and review the controls we have in place and educate our team on the latest in cyber threats and any other conditions that could affect our patients. Our goals are to protect the confidentiality, integrity, and availability of all information that we store and keep.

As part of our security protocols, we do not work with third party companies that outsource any aspect of our business operations to ensure all federal laws and regulations are upheld in protecting your privacy information. All of our team members receive rigorous HIPAA-training and we have stringent protocols and safeguards in place to ensure that in the event of a disaster, your medical records will be preserved and accessible. We maintain PCI compliance and will never write down or store your credit card information. Through our credit card processing vendor, cards may be stored securely in an electronic vault but never viewed by any of team members.

Learn about our privacy practices here.