Patient Information

Patient Privacy Policy

Privacy of your personal information is an important part of our office 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 we handle your personal information. It is
important to us to provide this service to our patients.

In this office, Dr. Rubin 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.

The following outlines what our office is doing to ensure that:

• only necessary information is collected about you;
• we only share your information 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 me 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 Patients' 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 maxillofacial
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 demonstrating purposes on an anonymous basis
• to complete and submit dental claims for third party adjudication and payment
• to comply with legal and regulatory requirements, including the delivery of patients'
charts and records to the Royal College of Dental Surgeons of Ontario in a timely fashion,
when required, according to the provisions 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 patients' charts
and records to the College in a timely fashion for regulatory 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

Your information may be accessed by regulatory authorities under the terms of the Regulated
Health Professions 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 conditions supply your insurer with your confidential medical
history. In the event this kind of a 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.