1. Realistic Expectations Agreement

I understand that while the practice aims to provide the highest quality care, dental outcomes cannot be guaranteed as perfect, and variations from ideal results are sometimes unavoidable.

2. Behavioral Standards

I agree to adhere to the following behavioral standards:

1. To be respectful and considerate to all staff and other patients.
2. To not engage in any disruptive behavior that could interfere with the provision of care to other patients.
3. To not engage in any behavior that could be construed as harassment, bullying, or discrimination.

Failure to comply with these standards may result in denial of service.

3. Communication of Concerns

If you have any concerns or complaints, please let us know as soon as possible. We take all concerns and complaints seriously, and will do our best to resolve any issues promptly.

4. Age Policy

Please note that the minimum age for patients is 16 years old. We are unable to see patients under the age of 16.

5. Acknowledgment of Previous Dental History

I declare that I have not had any disputes or complaints with previous dental providers.