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Policies

Privacy of your personal information is an important part of our office providing you with quality dental care. We understand the importance of protecting your personal information. We are committed to collecting, using and disclosing your personal information responsibly. We also try to be as open and transparent as possible about the way we handle your personal information. It is important to us to provide this service to our patients.

In this office, Dr. Yaroslav Vasyutyak, D.D.S. acts as the Privacy Information Officer.

All staff members who come in contact with your personal information are aware of the sensitive nature of the information that you have disclosed to us. They are all trained in the appropriate uses and protection of your information.

Attached to this consent form, we have outlined what our office is doing to ensure that:

  • Only necessary information is collected about you;
  • Storage, retention and destruction of your personal information complies with existing legislation, and privacy protection protocols;
  • We only share your information with your consent;
  • Our privacy protocols comply with privacy legislation, standards of our regulatory body, the Royal College of Dental Surgeons of Ontario, and the law.

Do not hesitate to discuss our policies with me or any member of our office staff. Please be assured that every staff person in our office is committed to ensuring that you receive the best quality dental care.

How Our Office Collects, Uses and Discloses Patients' Personal Information

Our office understands the importance of protecting your personal information. To help you understand how we are doing that, we have outlined here how our office is using and disclosing your information.

This office will collect, use and disclose information about you for the following purposes:

  • To deliver safe and efficient patient care
  • To identify and to ensure continuous high quality service
  • To assess your health needs
  • To provide health care
  • To advise you of treatment options
  • To enable us to contact you
  • To establish and maintain communication with you
  • To offer and provide treatment, care and services in relationship to the oral and maxillofacial complex and dental care generally
  • To communicate with other treating health-care providers, including specialists and general dentists who are the referring dentists and/or peripheral dentists.
  • To allow us to maintain communication and contact with you to distribute health-care information and to book and confirm appointments.
  • To allow us to efficiently follow-up for treatment, care and billing.
  • For teaching and demonstrating purposes on an anonymous basis
  • To complete and submit dental claims for third party adjudication and payment
  • To comply with legal and regulatory requirements, including the delivery of patients' charts and records to the Royal College of Dental Surgeons of Ontario in a timely fashion, when required, according to the provisions of the Regulated Health Professions Act
  • To comply with agreements/undertakings entered into voluntarily by the member with the Royal College of Dental Surgeons of Ontario, including the delivery and/or review of patient's charts and records to the College in a timely fashion for regulatory and monitoring purposes
  • To permit potential purchasers, practice brokers or advisors to evaluate the dental practice
  • To allow potential purchasers, practice brokers or advisors to conduct an audit in preparation for a practice sale
  • To deliver your charts and records to the dentist's insurance carrier to enable the insurance company to assess liability and quantify damages, if any
  • To deliver your charts and records to the dentist's insurance carrier to enable the insurance company to assess liability and quantify damages, if any
  • To invoice for goods and services
  • To process credit card payments
  • To collect unpaid accounts
  • To assist this office to comply with all regulatory requirements
  • To assist this office to comply with all regulatory requirements

By signing the consent section of the Patient Consent Form, you have agreed that you have given your informed consent to the collection, use and/or disclosure of your personal information for the purposes that are listed. If a new purpose arises for the use and/or disclosure of your personal information, we will seek your approval in advance.

Your information may be accessed by regulatory authorities under the terms of the Regulated Health Professions Act (RHPA) for the purposes of the Royal College of Dental Surgeons of Ontario fulfilling its mandate under the RHPA, and for the defense of a legal issue.

Our office will not under any conditions supply your insurer with your confidential medical history. In the event this kind of a request is made, we will forward the information directly to you for review, and for your specific consent.

When unusual requests are received, we will contact you for permission to release such information. We may also advise you if such a release in inappropriate.

You may withdraw your consent for use or disclosure of your personal information, and we will explain the ramifications of that decision, and the process.

Patient Consent

I have reviewed the above information that explains how your office will use my personal information, and the steps your office is taking to protect my information.

I know that your office has a Privacy Code, and I can ask to see the Code at any time.

I agree that Dr. Yaroslav Vasyutyak can collect, use and disclose personal information about as set out above in the information about the office's privacy policies.

Appointment Cancellation Policy:

When we make your appointment, we are reserving a room for your particular needs. We ask that if you must change an appointment, please give us at least 24 hours notice. This courtesy makes it possible to give your reserved room to another patient who would like it.

There is a charge for not showing up for scheduled appointments. Repeated cancellations or missed appointments will result in loss of future appointment privileges.

We feel that our patient's time is valuable. When your appointment is made, a room is reserved, your records are prepared, and special instruments are readied for your visit. Except for emergency treatment for another patient, you can expect us to be prompt. We, of course, would appreciate the same courtesy from you.

Dental Insurance Policies:

Many of our patients have dental insurance. While your dental insurance policy is an agreement between you and your insurance company, we will be happy to assist you in preparing and sending in the necessary forms. Please remember that no insurance company attempts to cover all dental costs. Payment to our office remains your responsibility, regardless of how much your insurance does or does not pay. For extensive treatments, most insurance companies require pretreatment estimates. We'll be happy to supply any information your dental insurance carrier needs and help you receive the maximum benefits.

Please bring the following documents with you to your first appointment:
* Your Benefits Booklet from your employer or union, which includes your dental benefits.
* Your wallet Identification Card for dentistry (this is usually different from your drug ID card)

Permanent Promotions


New patients without insurance receive 15% off on a cleaning and checkup