Patient Policies - Cumberland Pediatric Dentistry & Orthodontics

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Please click below to review our patient policies that we have in place across Cumberland Pediatric Dentistry & Orthodontic locations.

Notice Of Privacy Practices

Non-Discrimination Policy

Good Faith Estimate

HIPAA Authorization for Release of Health Information

Acknowledgment of Receipt of HIPAA Privacy Practices

Authorization Request for Restrictions and Confidential Communications

Notice of Privacy Practices (Spanish)

Privacy Practices (Continued)

If you need any of the forms in an additional language, please contact your local office.