Patient Consent Form

Privacy of your personal information is an important part of our office, just as providing you with quality dental care. We understand the importance of protecting your personal information and 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 very important to us to provide this service to all of our patients.

In this dental office, the Office Manager acts as the Privacy Information Officer. 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. Here is an outlined policy that our office follows to ensure you that:

  • Only the necessary information is collected from you.
  • We only share your information with your consent.
  • Storage, retention, and proper destruction of your personal information complies with the 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 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.