Resources

Report used if a death, or incident requiring emergency medical response, occurs in a dental office or dental clinic during the administration of or recovery from general anesthesia, deep sedation, moderate sedation, or minimal sedation.

Online submission (Once all required fields are completed, a "Click to Sign" button will display at the bottom of your screen.)

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 contact DANB directly at 800.367.3262 or through their website at danb.org/contact-us.

After some research, it was discovered that the legislative intent for creating the general Volunteer Health Services Registration process was based on the Board's Restricted Permit process. Please be patient as we reconstruct the Restricted Permit application. In the meantime, the Board will continue to receive Volunteer Health Services Registrations to volunteer your dental services at charitable dental clinic or organization. Your application must be submitted by you; no one may submit or attest to its veracity other than you. Your application shall consist of a completed application itself

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