Information regarding the requirements to comply with the No Surprises Act which became effective January 1st, 2022.  The No Surprises Act is an effort to protect individuals and provide transparency related to health care costs. Instructions as well as samples of the required notification and the Good Faith Estimate are included.

Understand how a patient portal can assist your practice with patient communication, record-keeping and overall office efficiency with this resource. Use our checklist to evaluate your practice’s need for a patient portal and valuable features to consider before implementation.  

Questions and answers from the American Academy on Pediatrics on masks for children during COVID-19.

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.

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.

Comprehensive guidance and templates for gathering new patient information.

Additional lab costs don't always have to be written off when a patient selects an upgraded service or material. Follow these tips and utilize this form to inform patients of their potential additional financial responsibility.

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

Summary of records release rules with customizable sample form. Patients have the right to access their record and can request paper, film or electronic copies.

Includes information on this patient right to restrict disclosure of patient health information to a dental benefit or health care plan and a sample form to use for a patient who requests such a restriction.

Notification to School Administrators regarding California Education Code to excuse student from absence due to medical, dental, optometrical and chiropractic treatment. Includes sample of School Excuse Note.

Sample form to request a consultation with a patient’s physician which may be necessary particularly for patients who have chronic conditions.

Format and content, patient access to records and requests to amend, disclosure of information, data breach notification, retention and disposal, transferring records in a sale.

This form is designed for internal office use only. It should not be shared with the patient and is intended to provide the practice with a way to document personal information about the patient to help refresh staff members’ minds prior to the patient visiting the practice.

There are many options to choose from, and when researching which options your practice will offer, you will likely come across practice owners who have had much success with certain methods and others who have had negative experiences with the same systems.

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.

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.

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.

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

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.

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.

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

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.

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

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.