Unencrypted email is not a secure form of communication. There is an inherent risk that content contained in such email/text messages may be misdirected, disclosed to or intercepted by, unauthorized third parties. Lexington Orthodontics will use the minimum necessary amount of protected health information in any communication. I agree that I am responsible for providing the dental practice any updates to my email address and/or mobile phone number.
I understand that the information that I have given today is correct to the best of my knowledge. I also understand that this information will be held in the strictest of confidence and it is my responsibility to inform the office of any changes in my child's medical status.
I hereby authorize the release of any information pertaining to my child's medical treatment necessary to process any insurance claims.