Resources

Form used to report any death or incident causing a patient temporary or permanent physical or mental injury occurring in a dental outpatient facility.

Suggested forms and Instructions for reporting an affiliated practice relation between a Dentist and a Dental Hygienist. 
(Please download, complete the document and submit to [email protected] or mail to 1740 W Adams, Suite 2470 Phoenix, AZ 85007)

(Please download, complete the document and submit to [email protected] or mail to 1740 W Adams, Suite 2470 Phoenix, AZ 85007)

(Please download, complete the document and submit to [email protected] or mail to 1740 W Adams, Suite 2470 Phoenix, AZ 85007)

Definitions

Confidentiality of medical records and payment records

Release of medical records and payment records to patients and health care decision makers; definition

Release of medical records and payment records to third parties

Release of medical records or payment records to third parties pursuant to subpoena

Charges

Immunity

Retention of records

Qualified immunity; health professionals; nonprofit clinics; previously owned prescription eyeglasses

Exceptions and exemptions; burden of proof; privileged communications

Duty to report abuse, physical injury, neglect and denial or deprivation of medical or surgical care or nourishment of minors; medical records; exception; violation; classification; definitions

Suspension of civil rights and occupational disabilities

Contracts; dentist; covered services; definition

Contracts; dentists; covered services; definition

Contracts; dentists; covered services; definition

Contracts; dentists; covered services; definition