Privacy of your personal information is an essential part of our office, just as providing you with quality dental care. We understand the importance of protecting your personal information. We are committed to collecting, using, and disclosing your personal information responsibly. We also try to be as open and transparent as possible about the way we handle your personal information. It is important to us to provide these services to our patients.

All staff members who encounter your personal information are aware of the sensitive nature of the information that you have disclosed to us. They are all trained in the appropriate use and protection of your information. In this consent form, we have outlined our office policy to ensure that:

By signing this form, you consent to the collection, use, and disclosure of your personal information for these purposes. If new purposes arise, your consent will be obtained in advance.

Your information may be accessed by regulatory authorities as permitted by law. We do not release your confidential medical history to insurers without your explicit consent; any such requests will be forwarded to you for approval.

You may withdraw your consent at any time, subject to legal or contractual obligations. We will explain any implications of doing so