Notice of Privacy Practices (HIPAA Form 5)

At Kiddos Dental, we are committed to protecting the privacy of your child's health information. Our Notice of Privacy Practices outlines how we may use and disclose your child's protected health information (PHI) to carry out treatment, payment, or health care operations, and for other purposes that are permitted or required by law.

It also describes your rights to access and control your child's protected health information. We are required to abide by the terms of this Notice of Privacy Practices, which may be revised from time to time.

Consent & Alternative Means of Communication

As part of our standard procedures (Form 5), we ask for your consent to communicate with you regarding your child's appointments, treatment options, and other health-related information through alternative means such as emails and text messages. This helps us ensure that you receive important updates in a timely and convenient manner.

Download the Patient Intake Form

Includes HIPAA Patient Consent, Emails & Texting Options (English & Spanish)