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Informed Consent Policy

The following describes the Informed Consent Policy for a 780-DENTIST Consultation.

Patient Consent to Use Teledentistry

By calling 780-DENTIST for the purpose of a dental consultation, and/or by selecting the Policies Approval section on the booking form while requesting an dental consultation, you are acknowledging that you have read and understand and agree to the Informed Consent Policy below and our website Privacy Policy regarding teledentistry services with 780-DENTIST.

Introduction

Teledentistry involves the use of electronic devices to enable 2-way communication between patients and their doctors at different locations for the purpose of general questions, oral assessments & diagnosis, follow-up assessments, and oral education.
Transmitted information may include any of the following:

  • Patient medical records
  • Live two-way audio and video
  • Patient materials such as prescriptions and lab requisitions may be sent to the patients via email upon request

Electronic systems used will incorporate network and software security protocols to protect the confidentiality of patient identification and imaging data and will include measures to safeguard the data and to ensure its integrity against intentional or unintentional corruption.

Expected Benefits:

  • Improved access to oral care by enabling a patient to remain in their home or workplace for oral assessments and consultations with a licensed dentist.
  • More efficient oral health evaluation and management.

Possible Risks:

As with any medical procedure, there are potential risks associated with the use of teledentistry. These risks include, but may not be limited to:

  • In rare cases, information transmitted may not be sufficient (e.g. poor resolution of images) to allow for appropriate medical decision making by the doctor.
  • Delays in medical evaluation and treatment could occur due to deficiencies or failures of the equipment.
  • In very rare instances, security protocols could fail, causing a breach of privacy of personal medical information.

By agreeing to this Consent Form, I understand the following:

  1. I understand the laws that protect privacy and the confidentiality of medical information also apply to teledentistry, and that no information obtained in the use of teledentistry which identifies me will be disclosed to researchers or other entities without my consent.
  2. I understand that I have the right to withhold or withdraw my consent to use the teledentistry in the course of my care at any time, without affecting my right to future care or treatment.
  3. I understand that I have the right to inspect all information obtained in the course of a teledentistry interaction, and may receive copies of this information for a reasonable fee.
  4. I understand that I may choose to make an in-person appointment at any time.
  5. I understand the doctor may recommend I schedule an in-person appointment to address issues that cannot be adequately addressed through teledentistry.
  6. I understand that teledentistry involves encrypted electronic communication of my personal medical information.
  7. I understand that I may expect the anticipated benefits for the use of teledentistry in my care, but no results can be guaranteed or assured.

Patient Consent to Use Teledentistry

By calling 780-DENTIST for the purpose of a dental consultation, and/or by selecting the Policies Approval section on the booking form while requesting an dental consultation, you are acknowledging that you have read and understand and agree to the Informed Consent and Privacy Policies regarding teledentistry services with 780-DENTIST.

If you have questions regarding our policies, you should submit a general inquiry to 780-DENTIST by email at info@780dentist.com to have them resolved to your satisfaction, prior to calling for or booking a dental consultation.

 

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780-DENTIST
(780)336-8478

Email Us

780DENTISTS@gmail.com

About Us

All consultations provided by a general dentist.

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SAT-SUN 10:00 - 14:00

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