Privacy of your personal information is an important part of our office 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 this service to our patients.
Information Collection and Use
- To deliver safe and efficient patient care
- To identify and to ensure continuous high-quality service
- To assess and provide you with your health care needs
- To advise you of treatment options
- To enable us to contact you and maintain communication with you
- To collect unpaid accounts, to process credit card payments
- To offer and provide treatment, care, and services in relationship to the oral and maxillofacial complex and dental care generally
- To communicate with other treating health-care providers, including specialists and general dentists who are the referring dentist and/or peripheral dentists
- To allow us to maintain communication and contact with you to distribute health-care information and to book and confirm appointments
- To allow us to efficiently follow-up for treatment, care, and billing
- For teaching and demonstrating purposes on an anonymous basis
- To complete and submit dental claims for third-party adjudication and payment
- To comply with legal and regulatory requirements, including the delivery of patients’ charts and records to the Royal College of Dental Surgeons of Ontario in a timely fashion, when required, according to the provisions of the
Regulated Health Professions Act
- To comply with agreements/undertakings entered voluntarily by the member with the Royal College of Dental Surgeons of Ontario, including the delivery and/or review of patients charts and records to the College in a timely fashion for regulatory and monitoring purposes.
- To prepare materials for the Health Professions Appeal and Review Board (HPARB)
- To assist this office to comply with all regulatory requirements
- To comply generally with the law
- To allow access by regulatory authorities under the terms of the
Regulated Health Professions Act (RHPA) for the defense of a legal issue
This office uses audio and video surveillance in non-treatment areas (e.g., waiting room, reception, hallways) to enhance security and safety
- You acknowledge that while in the non-treatment areas of our office you may be recorded by audio and video surveillance.
- Treatment areas, including consultation rooms and surgical operatories, do not contain any surveillance systems of any kind.
- Recordings are stored securely for a maximum of 30 days. Only designated practice owners and privacy/security officer may access the recordings unless required by law.
By signing below, you acknowledge that you have provided informed consent to the collection, use, and/or disclosure of your personal information, and consent to audio and video surveillance within this office, for the purposes outlined above. Should a new purpose arise for the use or disclosure of your personal information, your consent will be obtained in advance.
I consent to Southwestern Oral & Maxillofacial Surgical Centres collecting, using, and disclosing my personal information in accordance with the office's privacy policies. I authorize the release of information contained in electronically submitted claims to my benefits plan administrator and the Canadian Dental Association. I also authorize the communication of information related to coverage and services to the named Oral Surgeon. This authorization will remain in effect unless and until it is revoked in writing.