Patient Rights, Responsibilities and Privacy Information

As a patient of the UB School of Dental Medicine, you have both rights and responsibilities — as well as certain expectations of privacy.

Your Privacy

We encourage you to learn about your privacy at UB Dental.

Your Rights

 
As a patient in a Clinic in New York State, you have the right, consistent with law, to:
  • Receive service(s) without regard to age, race, color, sexual orientation, religion, marital status, sex, gender identity, national origin or sponsor;
  • Be treated with consideration, respect and dignity including privacy in treatment; 
  • Be informed of the services available at the center; 
  • Be informed of the provisions for off-hour emergency coverage; 
  • Be informed of and receive an estimate of the charges for services, view a list of the health plans and the hospitals that the center participates with; eligibility for third-party reimbursements and, when applicable, the availability of free or reduced cost care; 
  • Receive an itemized copy of his/her account statement, upon request; 
  • Obtain from his/her health care practitioner, or the health care practitioner’s delegate, complete and current information concerning his/her diagnosis, treatment and prognosis in terms the patient can be reasonably expected to understand; 
  • Receive from his/her physician information necessary to give informed consent prior to the start of any nonemergency procedure or treatment or both. An informed consent shall include, as a minimum, the provision of information concerning the specific procedure or treatment or both, the reasonably foreseeable risks involved, and alternatives for care or treatment, if any, as a reasonable medical practitioner under similar circumstances would disclose in a manner permitting the patient to make a knowledgeable decision; 
  • Refuse treatment to the extent permitted by law and to be fully informed of the medical consequences of his/her action; 
  • Refuse to participate in experimental research; 
  • Voice grievances and recommend changes in policies and services to the center’s staff,  the operator and the New York State Department of Health without fear of reprisal; 
  • Express complaints about the care and services provided and to have the center investigate such complaints. The center is responsible for providing the patient or his/her designee with a written response within 30 days if requested by the patient indicating the findings of the investigation. The center is also responsible for notifying the patient or his/her designee that if the patient is not satisfied by the center response, the patient may complain to the New York State Department of Health; 
  • Privacy and confidentiality of all information and records pertaining to the patient’s treatment; 
  • Approve or refuse the release or disclosure of the contents of his/her medical record to any health-care practitioner and/or health-care facility except as required by law or third-party payment contract; 
  • Access to his/her medical record per Section 18 of the Public Health Law, and Subpart 50-3. For additional information link to: http://www.health.ny.gov/publications/1449/section_1.htm#access
  • Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors; 
  • When applicable, make known your wishes in regard to anatomical gifts. Persons sixteen years of age or older may document their consent to donate their organs, eyes and/or tissues, upon their death, by enrolling in the NYS Donate Life Registry or by documenting their authorization for organ and/or tissue donation in writing in a number of ways (such as health care proxy, will, donor card, or other signed paper). The health care proxy is available from the center; 
  • View a list of the health plans and the hospitals that the center participates with; and 
  • Receive an estimate of the amount that you will be billed after services are rendered.

The dental care you will be receiving is being provided by student dentists. These student dentists are in the process of completing necessary academic as well as clinical requirements to obtain a Doctor of Dental Surgery (DDS) degree. If for any reason you have a concern or comment regarding the treatment that is being provided, always consult with your student dentist and supervising instructor first. If satisfaction is not received you have the right to access our Patient Advocate.

Patient Advocate

The UB School of Dental Medicine’s Patient Advocate can be reached:

  • By phone: (716) 829-2390
  • By mail: UB School of Dental Medicine, 325 Squire Hall, Buffalo, NY 14214-8006

Hours are by appointment.

You may also contact the New York State Department of Health’s Office of Health Systems Management.

Your Responsibilities

You have the responsibility to:

  • Provide to the best of your knowledge, accurate and complete information about present medical and dental history, past illnesses, hospitalizations, medications, and other matter relating to your health.  You have the responsibility to report changes in your health status;
  • Follow the treatment plan agreed upon by you and your dental care providers. This may include following instructions of allied dental health personnel as they carry out the coordinated plan;
  • Make known to your dental care provider that you understand and accept the treatment plan and that you know what is expected of you;
  • Comply with the rules and regulations of the UB School of Dental Medicine, The State University of New York at Buffalo, and the State of New York;
  • Be on time and available for your appointments (3-4 times per month);
  • Have a working phone number in order for your dental provider to be able to contact you to schedule appointments;
  • Be considerate and respectful of the rights of other patients and UB School of Dental Medicine personnel.  You are responsible for being respectful of the property of other persons and the University at Buffalo. Patients are expected to treat UB faculty, students and staff with courtesy and respect. Inappropriate behavior or comments of a cultural, ethnic or sexual nature will not be tolerated;
  • Provide proper childcare while you are being treated at the SDM clinics. Children are not to be left unattended and are not permitted to accompany an adult patient who is receiving treatment;
  • Be escorted into patient treatment areas by your student dentist. No other individual should accompany you into the treatment areas unless medically necessary or approved by the student dentist’s faculty;
  • Pay for service at the time it is provided.