In accordance with the Privacy Act (1988), all information collected by Tooth Town is treated as confidential. To protect your privacy and that of your child, Tooth Town operates in accordance with this act. We may use the information provided in the following ways:
• Disclosure to others involved in your child’s health care, including other health practitioners and hospital administration. This may occur through referral to other health practitioners.
• Disclosure to a medical defence organisation if a medico-legal matter arises.
• Clinical Teaching.
• Sending SMS appointment reminders via mobile phone using the numbers provided by you.
• Leaving voicemails identifying the caller, using the numbers provided by you.
• Sending correspondence via email using the email address provided by you.
• Administrative purposes in running our practice including debt management agencies if required.
• Utilisation of photographs and other images including x-rays for clinical teaching.
PARENT/GUARDIAN CONSENT
I have read the information above and understand the reason why my child’s information must be collected. I am also aware that Tooth Town has a privacy policy on handling patient information.
I understand that I am not obliged to provide information requested of me, but failure to do so may compromise the quality of dental care/health care and treatment given to my child.
I am aware of my rights to access information collected about my child, except in some circumstances where access might be legitimately withheld.
I understand I will be given an explanation in these circumstances. I understand that if information is to be used for any other purpose other than set out above further consent will be obtained.
I have authority to consent on behalf of my child. I consent to examination, x-rays, treatment, collection of clinical records (including clinical photographs). I consent to the handling of my child’s information by Tooth Town for the purposes set out above.
FINANCIAL
I will be responsible for any financial obligation incurred for my child’s treatment, and for incidental costs incurred and or legal fees necessary to recover the same. I understand that all accounts will be settled at the time of appointment. A minimum of 24 hours’ notice is required for any appointment changes.