Privacy Statement for Patients & Consent Form

Privacy of our patients’ personal information is important to us. We are committed to collecting, using and disclosing personal information responsibly.


Personal information for our purposes is: that information necessary for the provision of professional oral and maxillofacial health care services provided to you, and information necessary to administer this oral and maxillofacial surgery practice. Personal information includes all that information provided by you to us on our patient information and health/medical questionnaire forms collected at your first and subsequent visits. Personal information may also include any information provided by you to us during the normal course of communication between patient and any of our staff. We will use and disclose only information provided to us by you or another person acting on your behalf.


We are committed to protecting your personal information. We have established and implemented a variety of security measures to properly manage and safeguard your personal information from loss or theft, and unauthorized access. Access to your personal information shall be on a “need to know” basis.


Your personal information shall be disclosed to only those who have a need to know and the specific information disclosed shall be restricted to only that information relevant to that recipients need to know. Those who have a need to know include other dentists and health care providers (e.g. dental specialists, personal physicians). Further, the personal information disclosed to dental benefit providers is limited to only that personal information required by that provider. You may at any time designate any restrictions as to whom we may disclose your personal information or restrict the content of a disclosure.


We will retain your personal information for the period necessary to continue providing oral and maxillofacial health services to you, and for its related administration. We will destroy information in a secure manner when no longer needed for the provision of oral health services and is not required to be retained for compliance with provincial or federal regulations or statutes.


We are committed to providing you with open access to your personal information held by us. You may at any time ask us to see your records held by us and to request amendments to that information. We will provide access to you within a reasonable timeframe recognizing your desire for that information and our need to carry on our practice with limited interruption.
Should you have any questions, comments, or concerns, please bring them to the attention of the privacy officer. Should you wish to make a formal complaint regarding our privacy practices, please do so in writing to our privacy officer, Tammy Colter – Office Manager. We will be pleased to assist you.