Policies & Forms

Forms


Policies

Caregiver Participation

At Rimrock Pediatric Dentistry we encourage positive parent participation. Parents may accompany their child to the back office at any time with the exception of treatment performed under IV sedation. To help enhance your child’s dental experience we ask that you not use words which provoke negative feelings such as shot, pain, or hurt. Occasionally we may ask you to wait out in the waiting room if we feel that the child is acting out to get a response from a parent. Thank you for your confidence in us and we look forward to helping your child!

Patient Rights

As a patient and care giver of a patient of Rimrock Pediatric Dentistry you or your children have the right:

  • to schedule an appointment with your child’s dentist in a timely manner.
  • to see the dentist every time your child receives dental treatment.
  • to know in advance the type and estimated cost of treatment.
  • to expect dental team members to use appropriate infection and sterilization controls.
  • to ask about treatment alternatives and be told, in language you can understand, the advantages and disadvantages of each.
  • to ask your child’s dentist to explain all the treatment options regardless of coverage or cost.
  • to know the education and training of your dentist and the dental team.
  • to know the professional rules, laws and ethics that apply to your child’s dentist and the dental team.
  • to considerate and respectful care.
  • to expect information sufficient to give informed consent prior to the beginning of any treatment procedure.
  • to refuse treatment after being informed of the possible consequences of this decision.
  • to every consideration of privacy concerning your child’s dental care.
  • to expect that your child’s care meets the standard of care of the profession.
  • to emergency care within a reasonable amount of time.
  • to request and examine an itemized total bill regardless of the source of payment for services rendered.

Patient Responsibilities

As a patient and care giver of a patient of Rimrock Pediatric Dentistry you or your children have the responsibility: to provide, to the best of your ability, accurate, honest and complete information about your child’s medical history and current health status.

  • to report changes in your child’s medical status and provide feedback about your child’s needs and expectations.
  • to participate in your child’s health care decisions and ask questions if you are uncertain about your child’s dental treatment or plan.
  • to inquire about your child’s treatment options and acknowledge the benefits and limitations of any treatment that you choose.
  • for consequences resulting from declining treatment or from not following the agreed upon treatment plan.
  • To have your child’s treatment completed within a reasonable amount of time.
  • to keep your scheduled appointments.
  • to adhere to regular home oral health care recommendations.
  • to assure that your financial obligations for health care received are fulfilled
  • To give 48 hours’ notice prior to canceling and/or rescheduling a previously made appointment.