We are committed to providing care focused on YOU, the patient.

Patient-centered care ensures that you are an active participant in your treatment decisions and that your values, finances, and expectations are respected at all times.


Regarding your dental care, you have the right to:

  1. Be treated respectfully and courteously by students, faculty and staff
  2. Be informed of the academic environment and restrictions
  3. Receive dental care in a safe and secure environment, free from abuse or harassment
  4. Receive dental care without discrimination based on age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity or expression
  5. Receive dental treatment that meets the standard of care in the profession
  6. Expect that all people involved in your care will use proper infection controls
  7. Receive the information necessary to give informed consent prior to the start of any procedure and/or treatment so you understand the purpose, probable results, alternatives, and risks involved
  8. Request complete and current information about your dental condition in words that you can understand
  9. Participate actively in decisions regarding your dental care or designate a representative when appropriate
  10. Receive reasonable continuity of care -- keeping in mind the following:
  11. constraints of the academic schedule
  12. care will follow a comprehensive and appropriately sequenced treatment plan
  13. goals of treatment will vary according to individual needs.
  14. Receive an estimate of the cost of your dental treatment as well as continuing explanations of your bill, as requested
  15. Discontinue treatment at any time and be informed of the medical and dental consequences of your actions
  16. Receive emergency care in accordance with the conditions of your acceptance as a patient
  17. Expect that emergency treatment will be available during clinic hours. Call (319) 335-7499 between 8:00 am and 5:00 pm Monday to Friday to schedule an appointment. After-hours emergency care is available through the University of Iowa Hospitals and Clinics. Call (319) 356-1616 and ask for the general practice resident on call. There will be charges for
  18. emergency room services, in addition to any charges for required dental treatment)
  19. Discuss questions or concerns with any member of your health care team including faculty, student, staff, or patient representative
  20. Participate in a formal grievance procedure
  21. Bring a service dog to your dental appointments. The service dog will remain with another
  22. person in the waiting room and NOT in an operatory area. (Under the American Disabilities Act,
  23. the service dog must have been trained to work or perform tasks for an individual with a
  24. disability.) The task(s) performed by the dog must be directly related to the person’s disability.
  25. Emotional support dogs do not qualify as service dogs and may not enter the building
  26. Have access to foreign language interpreting services when needed
  27. Request and expect that sign language interpreting will be available during the appointment,
  28. provided the college is given adequate notice

Regarding your Protected Health Information (PHI), you the right to:

  1. Expect that all communications and records pertaining to your care will be treated confidentially by the dental care team.
  2. Request in writing to review your health information.
  3. Receive a description of how we (or our business associates) have disclosed patient health information for purposes other than treatment, payment, and healthcare operations for the last six years. (This notice took effect May 30, 2015 and will remain in place until it is replaced.)
  4. Request in writing to receive copies of your treatment record at no charge.
  5. Complete an “Authorization for Release of Protected Health Information (PHI) Consent Form”
  6. Request in writing that we place additional restrictions on our use or disclosure of your health information.
  7. Request in writing that we amend your health information.
  8. Review a copy of the College of Dentistry's “Notice of Privacy Practices” in our clinics or request a paper copy to take with you.
  9. Request in writing that we communicate with you about your health information by alternative means or locations.
  10. Receive protected health information by email, provided you have completed a “Consent to Communicate PHI By Email” form.


Regarding dental care, you have the responsibility to:

  1. Abide by collegiate rules and policies, as informed by collegiate personnel
  2. Be respectful of clinic personnel, other patients, and clinic property
  3. Follow clinic policy that patients under the age of 18 and or dependent adults must be accompanied by a parent or legal guardian
  4. Make arrangements for the care of your small children or dependent adults during your dental appointments
  5. Keep scheduled appointments and arrive on time or give 48-hour notice for a change in appointment. Failure to keep scheduled clinic appointments may result in a discontinued relationship between you and the college
  6. Provide accurate and complete information about your health, including medications and past or present medical problems
  7. Read and sign the “Patient Treatment Consent/Agreement Form”
  8. Provide current information regarding your health insurance
  9. Follow treatment recommendations given by your dental care provider after reasonable treatment options and fee estimates are presented
  10. Notify a provider if you do not understand information about your care or treatment.
  11. Inform your provider if you are not satisfied with any aspect of your care.
  12. Pay promptly all fees for treatment you have received
  13. Attend your appointments free from the influence of alcohol or recreational drugs
  14. Refrain from bringing firearms and/or weapons into the building
  15. Keep cell phones on silent or vibrate mode while in the building and refrain from using cell phones in the operatories and waiting rooms
  16. Refrain from taking videos or photographs without permission
  17. Refrain from bringing pets and emotional support animals into the building (refer to Patient Rights section)

Concerns and Complaints:

  • It is the responsibility of all UI College of Dentistry and Dental Clinics faculty, students, and staff to listen to patient concerns, as well as those raised by family members or visitors.
  • To discuss a complaint, you may contact a student, staff, faculty member, or a patient representative. The issue will be thoroughly investigated, and the outcome will be communicated to you.
  • All complaints and concerns are treated confidentially. Patients who express a concern or complaint will not have their future treatment compromised in any way.
  • Patients can provide feedback through our collegiate website and by email through our Patient Satisfaction Surveys.
    • Must have a “Consent to Communicate PHI By Email” on file prior to submission.
  • Survey cards are available in the clinic reception areas.

Contact Information

For more information about our patient rights and responsibilities practices, or for additional copies of this notice, please contact us:

Clinic Administration
W440 Dental Science Building
University of Iowa College of Dentistry and Dental Clinics
Iowa City, IA 52242
Telephone: 319-335-7431

Notice of Privacy Practice