Emergency Dentistry &
NW Dental Clinic
We want make our website users aware of our
1. The information provided on this site is for
2. This site is made to highlight the services we
provide at the dental office.
3. We guarantee that all the information provided
on this site is to the best of the knowledge of the dental
4 At Expressions Dental we reserve all the rights
to change any and all the content.
5. We respect client confidentiality and assure
that all the information provided by you will be handled with the
utmost confidentiality protected by and is in accordance with the
Alberta dental association governing laws.
6. We disclose any personal information of the
patient to any third parties, insurance companies, other dental
offices including dental specialist office with the consent of the
7. Information provided by our patients is under
no circumstances used for commercial use or distribution of any
8. All conflict resolution is done within 24 to
To further protect the privacy of our patients
and that we keep our promises and provide our dental services, our
dental services are governed by the Alberta dental association who
issues us a certificate to conduct these services.
This site is the sole property of Gurpreet Gill
Professional Corporation and we reserve all rights to advertise all
and any services offered at our office at any time.
Expressions Dental Calgary
41 Crowfoot Rise NW
Calgary, AB T3G 4P5
Phone: (403) 252 7733
We collect information from our
patients such as names, home addresses, work addresses, home
telephone numbers, work telephone numbers, and e-mail addresses.
(Collectively referred to as “Contact Information”).
Contact Information is collected and used for the following
To open and update patient files.
To invoice patients for dental services, to process credit
card payments, or to collect unpaid accounts.
To process claims for payment or reimbursement from
third-party health benefit providers and insurance companies.
To send reminders to patients concerning the need for
further dental examination or treatment.
To send patients informational material about our dental
Contact Information is disclosed to third party health
benefit providers and insurance companies where the patient has
submitted a claim for reimbursement or payment of all or part of
the cost of dental treatment or has asked us to submit a claim
on the patient’s behalf.
Financial information may be collected in order to make
arrangements for the payment of dental services.
We collect information from our patients about their health
history, their family health history, physical condition, and
dental treatments. (Collectively referred to as “Medical
Information”) Patients’ Medical Information is collected and
used for the purpose of diagnosing dental conditions and
providing dental treatment..
Patients’ Medical Information is disclosed:
To third party health benefit providers and insurance
companies where the patient has submitted a claim for
reimbursement or payment of all or part of the cost of dental
treatment or has asked us to submit a claim on the patient’s
To other dentists and dental specialists, where we are
seeking a second opinion and the patient has consented to us
obtaining the second opinion.
To other dentists and dental specialists if the patient,
with their consent, has been referred by us to the other dentist
or dental specialist for treatment.
To other dentists and dental specialists where those
dentists have asked us, with the consent of the patient, to
provide a second opinion.
To other health care professionals such as physicians if the
patient, with their consent, has been referred by us to the
other health care professional for either a second opinion or
If we are ever considering selling all or part of our dental
practice, qualified potential purchasers may be granted access
as part of the due diligence process to patient information in
order to verify information important to the potential sale. If
this occurs, we will take steps to ensure that the prospective
purchaser safeguards all personal information.
Dentists are regulated by the Alberta Dental Association and
College which may inspect our records and interview our staff as
part of its regulatory activities in the public interest.
I consent to the collection, use and disclosure of my
personal information as set out above.
Two business day cancellation policy in effect for
If we are ever considering selling all
or part of our dental practice, qualified potential purchasers may
be granted access as part of the due diligence process to patient
information in order to verify information important to the
potential sale. If this occurs, we will take steps to ensure that
the prospective purchaser safeguards all personal information.
Dentists are regulated by the Alberta
Dental Association and College which may inspect our records and
interview our staff as part of its regulatory activities in the
As a patient in our clinic, it
will be your responsibility to keep scheduled
appointments. The clinic will require
notification of cancellation of at least
two full business days
prior to the appointment during the week and
appointment for Saturdays including Dr. Gill’s
appointments. For all of Dr. David’s & Dr.
Daya’s root canal appointments we require
three full business days
(Excluding SUNDAYS & Holiday’s) notice in
order to cancel or re-schedule.
appointments booked for two hours or more
require a $100 deposit which will be applied
towards treatment done that day.
appointments missed or cancelled without
sufficient notice are subject to a $100
administrative charge. (Including emergencies)
appointments for Ortho Study Record (OSR), Root
Canals (RCT), Zoom Treatment (2 hrs) or
appointments booked for two hours or longer have
a three business day cancellation with $100
of x-rays maybe subject to an administration
Patient portions outstanding,
after insurance coverage or otherwise, have to
be paid within 30 days of treatment done if they
are not collected the day of the treatment. If
balance payment is not made promptly then there
will be an administrative charge after 30 days
of outstanding non-payment and the account will
be sent to collections without notice and 28%
interest will be charged. Any no show or missed
appointments are subject to the same charging
policy which includes all appointments made from
any one of our websites.
Please note that we do not
accept any change of appointments or
cancellations via email or online submissions
through any of our websites. All emergency and
last minute appointments are given using a
credit card number on file only You as a patient
authorize us to charge the credit card on file
if you fail to show up for the appointment.
All phone consultations are
subject to a phone consultation charge of $50 at
the discretion of the dentist.
I understand and agree that Dental
health and accident insurance policies are an arrangement between an
insurance carrier and me. Furthermore, I understand that Dr.
Gurpreet Gill’s office will prepare all necessary reports and forms
to assist in making collections from the insurance company and that
any amount authorized to be paid directly to Dr. Gurpreet Gill will
be credited to my account upon receipt. However, I clearly
understand and agree that all my services rendered me are charged to
me and that I am personally responsible for payment. Emergency
patients for their first visit have to pay upfront for their
treatment and all subsequent visits can be direct billed at the
I also understand
that if I suspend or terminate my care at this office, any
outstanding charges for professional services rendered to me will be
immediately due and payable. I agree that I will be responsible for
all attorney and legal fees if legal action becomes necessary to
collect this account.
Please be advised that we DO NOT accept
any appointment cancellations by email or by our online appointment
request system and cancellations not made by phone will be subject
to the above charges. We only accept cancellations over the phone
during regular business hours and no cancellations are accepted on
Sunday's and stat holidays.
First & Last Name:
Yes I accept privacy & Financial policy:
No I do not accept:
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