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Combined Consents Forms

Collection, Use, and Disclosure of Personal Information.

Step 1 of 3

  • Privacy of your personal information is an important part of our office providing you with quality dental care. We are committed to collecting, using and disclosing your personal information responsibly. We also try to be as open and transparent about the way we handle your personal information. All team members are trained in the appropriate uses and protection of your information. Please, do not hesitate to discuss our policies with any member of our team.

    Blue Quill Dental Centre will collect, use, and disclose information about you for the following purposes:

    • to offer and provide treatment, care and services in relationship to dental care to communicate with other treating health care providers, including specialists, general dentists and physicians
    • to allow us to maintain communication and contact with you (ie. book and confirm appointments)
    • to allow us to efficiently follow up for treatment, care and billing to comply with legal and regulatory requirements when required
    • to invoice for dental services, process credit card payments and collect unpaid accounts
    • to process claims from insurance companies and third party health benefit providers

    We collect information about medical health history for the purpose of aiding us to provide optimal dental treatment. Your dental care is directly tied to your overall well-being, and medical information may be disclosed to:

    • other dentists and dental specialists for treatment or second opinions
    • other health care professionals, such as physicians, as needed
    • insurance companies and third party health benefit providers

    In addition, dentists are regulated by the Alberta Dental Association, which may inspect Blue Quill Dental Centre records and interview staff as part of its regulatory activities.

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