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Privacy Policy for
Collection, Use and Disclosure of Personal
Information:
Privacy of your personal information is an important part of our office
in providing you with quality dental care. We understand the
importance of protecting your personal information. We are
committed to collection, 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 use to provide this service to our patients.
In this
office, Dr. Rick Merritt / Christine Romard act as the Privacy
Information Officers.
In addition, all staff
members who
come in contact with 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 uses and protection
of your information.
Attached to
our consent form, we have outlined what our office is doing to ensure
that:
- only
necessary information is collected about you;
- information is only
shared with your consent;
- storage, retention and
destruction of your personal information complies with existing
legislation, and privacy protection protocols;
- our privacy protocols
comply with privacy legislation, standards of our regulatory body, the
Royal College of Dental Surgeons of Ontario, and the law.
Do not
hesitate to discuss our policies with Dr. Rick Merritt / Christine
Romard or any member of our office staff. Please be
assured that every staff person in our office is committed to ensuring
that you receive the best quality dental care.
How our Office Collects,
Uses and Discloses Patient Personal Information:
Our office understands
the importance of protecting your personal information. To help
you understand how we are doing that, we have outlined here how our
office is using and disclosing your information. This office will
collect,
use and disclose information about you for the following purposes:
- to deliver safe and
efficient patient care
- to identify and to ensure
continuous high quality service
- to assess your health
needs
- to provide health care
- to advise you of
treatment options
- to enable us to contact
you
- to establish and maintain
communication with you
- to offer and provide
treatment, care and services in relationship to the oral and
maxillo-facial complex and dental care generally
- to communicate with other
treating health-care providers, including specialists and general
dentists who are the referring dentists 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
demonstration purposes on an anonymous basis
- to complete and submit
dental claims for third party adjudicate and payment
- to comply with legal and
regulatory requirements including the delivery of patient charts and
records to the Royal College of Dental Surgeons of Ontario in a timely
fashion, when required, according to the provision of the Regulated
Health Professions Act
- to comply with
agreements/undertakings entered into voluntarily by the member with the
Royal College of Dental Surgeons of Ontario, including the delivery
and/or review of patient charts and records to the College in a
timely fashion for regularly and monitoring purposes
- to permit potential
purchasers, practice brokers or advisors to evaluate the dental
practice
- to allow potential
purchasers, practice brokers or advisors to conduct an audit in
preparation for a practice sale
- to deliver your
charts and records to the dentist’s insurance carrier to enable the
insurance company to assess liability and quantify damages, if any
- to prepare materials for
the Health Professions Appeal and Review Board (HPARB)
- to invoice for goods and
services
- to process credit card
payments
- to collect unpaid accounts
- to assist this office to
comply with all regulatory requirements
- to comply generally with
the law
By signing the consent
section of our Patient Consent Form, you have agreed that you have
given your informed consent to the collection, use and/or disclosure of
your personal information for the purposes that are listed. If a
new purpose arises for the use and/or disclosure of your personal
information, we will seek your approval in advance.
Your information may be
accessed by regulatory authorities under the terms of the Regulated
Health Professional Act (RHPA) for the purposes of the Royal
College of Dental Surgeons of Ontario fulfilling its mandate
under the RHPA, and for the defence of a legal issue.
Our office will not under
any condition supply your insurer with your confidential medical
history. In the event that this kind of request is made, we will
forward the information directly to you for review, and for your
specific consent.
When unusual
requests are received, we will contact you for permission to release
such information. We may also advise you if such a release is
inappropriate.
You may withdraw your
consent for use or disclosure of your personal information, and we will
explain the ramifications of that decision, and the process.
PATIENT INFORMATION SHEET:
How to Access the Privacy
Process in our Office
Privacy of
your personal information is an important part of our office on
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 in which we handle your personal
information. It is
important to us to provide this service to our patients.
Our Privacy Information Officers are Dr. Rick
Merritt / Christine Romard and they can be reached at:
Commissioners Court Plaza
509
Commissioners Rd., West at Wonderland
Road
London, Ontario
N6J
1Y5
Phone:
519-679-DOVE
Fax:
519-473-7435
Web:
www.dovedentalcentres.com
Dr.
Rick
Merritt / Christine Romard will attempt to answer any questions or
concerns that you might have. If you do have a concern
and / or wish to make a complaint to us about our privacy practices,
including asking questions about the contents of your charts or
records, you must make your request in writing. Please send it to
our office’s Privacy Information Officer by surface mail, fax or e-mail.
Our Privacy Information
Officer will promptly acknowledge receipt of your complaint in writing,
and will ensure that it is investigated thoroughly. You will be
provided with a formal decision in writing, and the reason for the
decision.
If you are dissatisfied
with the decision, you may seek further information from the Privacy
Commissioner of Canada. We have included
all the necessary contact information below.
Postal Address:
Privacy Commissioner of Canada
112 Kent Street
Ottawa, Ontario
K1A 1H3
General Inquiries:
Phone:
613-995-8210
Toll Free:
1-800-282-1376
Fax:
613-947-1376
Our privacy policies and
procedures comply with federal legislation called the Personal
Information Protection and Electronic Documents Act (PIPEDA).
This very complex law does provide for some exceptions to the privacy
principles that are too detailed to outline here. Our Privacy
Code sets out
this dental office’s commitment to protecting your private health and
personal information. It is available upon request by asking any
of our office staff.
Please be assured that
every staff person in our office is committed to ensuring that you
receive the best quality dental care.
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