Patient Forms

Terms & Conditions

Here at Epic Dental, we work diligently to protect our patient's rights and privacy. Requesting an appointment via our Internet portal is considered part of what HIPAA has identified as electronically protected information (ePHI). Unfortunately, despite the best efforts we make or take, there are people or entities that may attempt to intercept the data you transmit to us. By checking the box, and electronically making an appointment, you understand that you are making an appointment over the internet and that Epic Dental will keep this information confidential but cannot guarantee that others, outside of our practice, may not illegally intercept this communication. As a result of continuing, you are sending this transmission and accepting the inherent risk(s) associated with making this request for an appointment. As an alternative, you are always welcome to contact our office via telephone to schedule your appointment.