Patient Management

This training guides staff through the state and HIPAA requirements for providing access. Instructions on staff presentation are included.

Form to be completed by legal guardian to authorize a caretaker (non legal guardian) to accompany a minor to his/her dental appointment. 

This form allows for a non-legal guardian to consent to a minor patient’s treatment. It must be signed by a parent or legal guardian.

Summary of legal obligations of dental licensees and certain dental practice employees as mandated reporters to report known or suspected cases of abuse. 

This guide demonstrates patient record best practices. Thorough and accurate patient records are one of your most important tools for telling the story of what happens during treatment.

Are you confident your patients understand the necessity of diagnostic X-rays? Here are some of the questions you may get from patients and guidance on how to best respond.

This form should be completed by each new patient or a new patient’s legal guardian. Additionally, this form should be reviewed at each patient appointment with changes noted and signed for. Used with permissions from TDIC.

Use this sample form to obtain patient consent for use or disclosure of patient information as required by HIPAA and state law.

Sample consultation request for dental treatment fax communication form. Used with permissions from TDIC.

Utilize this form when offering patients automatic credit card payments. Be certain to comply with your merchant card processor's security standard for this type of payment.

A credit card company may request information when a patient disputes a charge to a dental practice. Use these resources to respond to the company.

Form designed for a provider who wishes to collect more in-depth dental health history that is not covered on the Confidential Health History Form, as well as assess the patient’s oral health and/or cosmetic concerns.

Sample letter to patient discussing the necessity of radiographs. Courtesy of TDIC.

Use for existing minor patients whose legal guardians of record have experienced a relationship change (divorce). Send a letter to both parents; responses will help you determine if you need to update the patient information and patient financial agreement.

Consider this checklist a comprehensive overview of areas and tactics to consider when creating your practice’s external marketing plan.

Tool to utilize during the patient financial discussion to document financial options presented, patient obligation and financial consent.

Sample informed consent forms to aid in the face-to-face informed consent discussion between the dentist and patient. Available in English, Chinese, Japanese, Korean, Russian, Spanish, Tagalog, Traditional Chinese, and Vietnamese.

Informed Refusal of Treatment to be signed by patient, provider and witness to document the discussion between the patient and provider on risks of declining recommended treatment.

This chapter addresses Patient Considerations including but not limited to: Examination and Diagnosis, Communications and Records.

Dentists are obligated to make reasonable arrangements for the emergency care of patients of record. Dental benefit plans require the same of contracted providers. Failure to make such arrangements may result in charges of patient abandonment. Resource in

Questions and answers on obtaining consent for minor children with divorced parents or no parents, coordination of insurance plans between parents and step-parents, and who can access records of minor children.

Information a dental practice should collect when creating a New Patient Form. Annual verification should be done to verify if any changes are needed, such as employer or contact info.

Comprehensive guidance and templates for gathering new patient information.

Dental practices that offer patients commercial credit financing products (credit cards, lines of credit or loans) in the dental office are required to disclose certain information and are prohibited from specific practices. 

This document provides sample language for obtaining a patient’s acknowledgment of responsibilities and receipt of information, for obtaining a patient’s affirmation that provided information is correct and the patient agrees to treatment and payment terms.