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Patient Privacy Information

Notice of Privacy Practices (PDF) 

As a patient of the UB School of Dental Medicine, you have both rights and responsibilities.

YOU HAVE THE RIGHT TO:

  • Understand and use these rights. If for any reason you do not understand or need help, the school will provide assistance. 
  • Be treated with dignity and respect, regardless of your race, religion, age,  sex, beliefs, lifestyle, national origin, disability, or sexual orientation.
  • Receive confidential treatment in a clean and safe environment, free of unnecessary restraints.
  • Receive continuous care to completion of planned treatment with knowledge of anticipated cost.
  • Receive emergency, incremental and total care consistent with the standard of care in the profession.
  • Receive education, counseling and explanations to your questions.
  • Know the names, positions and functions of any personnel involved with your care.
  • Receive complete information about your diagnosis, treatment and prognosis.
  • Receive all the information that you need to give informed consent for any proposed procedure or treatment. This information shall include possible risks and benefits of the procedure or treatment and of not receiving treatment.
  • Refuse or change your mind regarding examination and treatment and be told what effect these actions may have on your health.
  • Refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.
  • Privacy and confidentially of all information and records regarding your treatment.
  • Participate in all decisions about your treatment.
  • Review your records with a clinician and obtain a copy of your record for which the School of Dental Medicine can charge a reasonable fee.
  • Receive an itemized bill and explanation of all charges.
  • Complain without fear of reprisals about the care and services you are receiving.
  • Have access to a Patient Advocate. Complaints made to the Patient Advocate should be submitted in writing. 

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.

The UB School of Dental Medicine’s Patient Advocate can be reached by phone at (716) 829-2390 or 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.

YOU HAVE A 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, your student dentist, and supervising faculty. This may include following instructions of other dental health care providers 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. (up to three times a 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 at 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 and will result in you being discharged as a patient.
  • 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.