Protecting Your Privacy While Protecting Your Oral Health

Our Privacy Policy

At Square One Dental we take your privacy very seriously. We protect the privacy of our patients by:

• collecting only personal information that is reasonable for our purposes in serving you
• obtaining your consent for how and when we disclose or share your personal information
• having safeguards in place to protect your personal information at times of collection, use, storage, disclosure, and exchange with others as our patients have given their consent
• sharing your personal information only for the purposes and with those agreed upon in the consent form signed by the patient, or otherwise permitted by provincial or federal law
• ensuring that any contractors hired by our office who may have access to any personal information have confirmed they will take steps to protect the privacy of your personal information
• training our staff and adapting our physical, telephone and electronic environment to protect your personal information
• processing the necessary forms and documentation to protect your personal information
• ensuring the personal information kept on you is complete, accurate, and up to date
• letting you see and request corrections to the personal information we have on record
• making our Privacy Officer available to answer your questions and concerns about our Privacy Policy and to deal with written complaints regarding personal information, and
• periodically reviewing implementation of our Privacy Policy to ensure fulfillment of our commitment to your privacy protection while we promote and protect your oral health!

Our Personal Information Procedures

We have appointed a Privacy Officer, who has undertaken the duties as our principal advisor and issues manager regarding personal information protection. Should you have the need to speak to our Privacy Officer directly, please ask any one of our staff and you will be directed to our Privacy Officer. On your behalf, our staff are trained in personal information protection, we review our information collection procedures and consent forms on an ongoing basis, and we ensure that any contractors we hire who might have access to your personal information also take steps to protect the privacy of your personal information.

At the office of Dr. Sheila Shellborn and Dr. Len V. Klug, we have a privacy policy in place for patients and employees. The Personal Information Protection Procedures contained in this brochure tell you how we fulfill the commitment to patients in our Privacy Policy at Square One Dental.

The Personal Information Protection Procedures outlined here tell you how we fulfill the commitment to patients in our Privacy Policy.

The Personal Information We Collect and Share

We collect contact information, medical information and financial information about our patients. The reasons we collect this information are outlined on the Consent Form you sign at time of collection. The information is used and disclosed only for those purposes.

Contact Information is disclosed to third party health benefit providers and insurance companies with the consent of the patient, where the patient has submitted a claim for reimbursement or payment of all or part of the cost of dental treatment or has requested the dentist to submit a predetermination of dental benefits on the patient's behalf.

Patients' Medical Information is disclosed to third party health benefit providers and insurance companies, with the consent of the patient, where the patient has submitted a claim for reimbursement. Medical information is disclosed, with the consent of the patient, to other dentists and dental specialists, or to other health care professionals such as physicians.

Financial information is collected for payment processing purposes. It is not shared with third parties without your consent, unless permitted by law for outstanding bill collection purposes.

Protection of Your Personal Information in Our Records

Our records containing your personal information are stored in a secure place.

Our electronic records are stored on hardware that is secure. Passwords are used on all of our computers. We take care to protect screen monitors from public viewing in the office.

Paper records are transferred outside our office in sealed envelopes by secure methods and with reputable carriers. Telephone discussions with patients in the office are carried out with sensitivity to protecting personal information. Electronic information is transferred in secure files, and anonymized wherever possible.

We do not share your personal information outside our office for any marketing, promotional, publicity, educational or research purposes without your consent.

Our staff is trained to handle your information only through the protective measures outlined in our privacy procedures.

If we hire consultants or contractors who might have access to any of your personal information, we will take steps to ensure that the consultant or contractor takes steps to protect the privacy of your personal information.

Access to Your Personal Information

You can make a request to look at your personal information by asking the staff. They may refer you to our Privacy Officer. We will attempt to help you understand the reasons we have the information that is in your record.

You may request that we consider making changes to your personal information if it is not accurate, incomplete, or not up to date. If you believe there is a mistake in your personal information, you may ask for consideration that it be changed.

If you request a copy of your record, we will provide it in a reasonable time. If we charge you for the cost of copying, we will let you know in advance what the cost will be.

Storage and Destruction of Personal Information

We are required by legislation and regulation to keep records containing personal information for specified periods of time. We keep your records a maximum of 10 years from your last service, even if you move from our office. We destroy personal information in paper records by shredding it. We destroy electronic personal information by deleting it. When discarding hardware, we make sure the hard drive is destroyed.

Our Privacy Protection Partnership

1. Make sure the personal information you provide us is complete and accurate.
2. If you have questions or concerns about the purposes and methods for collection, use, disclosure, sharing, storage or destruction of your personal information by us, please bring them to our attention.
3. Please complete the required consent forms supplied by our office for our collection, use, storage, disclosure, sharing and destruction of your personal information.
4. If you disclose personal information to another source that may need to share it with us, e.g. your doctor, your employer, or your dental plan carrier, please complete the required consent forms presented by them to affect that authorized information exchange.
5. Please respect the privacy of other patients in our office when you are here.
6. Please respect the privacy of our staff in your dealings with our office.
7. If you wish to see or change the personal information on your record other than for updating purposes, please make that request to our Privacy Officer.
8. If you have concerns or a complaint about our privacy policies or procedures, please contact our Privacy Officer to discuss the procedure for communicating those to our office.

Contact Us

If you have a concern about your personal information that is not being resolved and wish to file a complaint, please do so in writing to our Privacy Officer.

Our Privacy Officer can be reached in the following ways:

Resources

For more information about the Alberta Personal Information Protection Act (PIPA), The Alberta Health Information Act (HIA) or the federal Personal Information Protection and Electronic Documents Act (PIPEDA), you may wish to visit the website of the Office of the Information and Privacy Commissioner of Alberta at www.oipc.ab.ca, The Government of Alberta Private Sector Privacy site at www.psp.gov.ab.ca, or the Office of the Privacy Commissioner of Canada at www.priv.gc.ca.

Disclaimer - The designations; Square One Dental, Dr. Sheila A. Shellborn, The Office of Dr. Sheila A. Shellborn and Sheila A. Shellborn Professional Corporation all represent the same entity.

Disclaimer - The designations; Dr. Len V. Klug, The Office of Dr. Len V. Klug and Len V. Klug Professional Corporation all represent the same entity.