Dental Clinic - Dental Hygiene Clinic

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					           Client Bill of Rights                       New Directions to USI Campus                        University
The faculty and students of the University
of Southern Indiana Dental Hygiene Pro-
                                                  From I- 62 (Lloyd Expressway) take University
                                                                                                               of
gram are here to provide you with compre-
hensive dental hygiene care. As a client in        Parkway Exit. Turn south at top of exit.             Southern Indiana
our clinic you have the right to expect:
                                                   Take University Parkway to entrance of USI
   To be treated with respect and consid-         Campus, turn right on first road (Clarke Lane)
    eration without discrimination.                just before the Health Professions Center.
                                                        (Star     on Building!)
                                                                                                      Dental Hygiene
   Confidentiality of all information


    related to your care.
    A thorough assessment of your needs.
                                                   Park in lot behind from the HP Center.
                                                                                                          Clinic
   To receive complete and current               Enter through the double doors at the NW corner
     information about your oral health            of building. The Dental Hygiene Clinic is on the
    condition and treatment.                       left of entrance.
   To be treated as a partner in care, par-
    ticipating in goal setting and planning                                       N
    of treatment including the opportunity
    to discuss treatment, treatment alter-                                        University
    natives, and expected outcomes of                                             Parkway

    treatment with the supervising dental
    hygiene faculty and the dental hygiene
                                                                                      sville
    student.                                                                      Evan
                                                                              n
   To be informed of all aspects of your                         Mt. Ve
                                                                        rno


    care and sign an informed consent.
   To receive treatment that meets the
    standard of care in the dental hygiene                                                                  College
    profession which includes dental hy-
    giene care based on your individual                                                                         of
    needs.                                                                                                  Nursing
   To be taught how to achieve and main-
    tain your oral health.                                                                                     and
   Reasonable continuity of care and
    completion of treatment.                                                                           Health Professions
   Appropriate and timely referrals for                                                              8600 University Blvd.
    other needed services.
   The University of Southern Indiana                                                                     Room 1040
    Dental Hygiene Program to comply
    with the infection control guidelines                                                             Evansville, IN 47712
    mandated by the Occupational Safety
    and Health Administration (OSHA) and
    recommended by the Centers of Dis-
    ease Control and Prevention (CDC).
                                                                                                         812.464.1706
                                                                                                        Appointment Date

                                                                                                      ________________________
  Dental Hygiene                                       Clinic Fees                       Did you know…
      Clinic                                    Dental Hygiene Treatment
                                                Adults                     $35.00          Periodontal disease, a serious form of
 Thank you for your interest in                 Seniors
 becoming a client in the University of                                                   gum disease, may be associated with greater
 Southern Indiana Dental Hygiene                  Age 60 & above            $15.00        risks for heart disease and strokes as well as
 Clinic. The Dental Hygiene Clinic              Children                                  diabetes management?
 offers dental hygiene services to adults         Age 10 & Under            $10.00           Bacteria from periodontal disease may
 and children of all ages. All services                                                   enter the blood stream causing blood clots
 are performed by students and are                Age 11—17                 $20.00
 supervised and evaluated by dental            Radiographs and/or sealants
                                                                                          that clog the arteries and cause a build-up of
 hygiene faculty.                                                                         fatty deposits inside the heart. Periodontal
                                             are included in the above fees.
                                                                                          disease may also make diabetes harder to
  You can plan on approximately                                                           control by causing blood sugar levels to rise.
 3 1/2 hours being devoted to your           Radiographs And Sealants Only                If you have heart disease or a heart condition,
 care. Please keep this in mind
                                               When requested by a Dentist                taking care of your teeth and gums is very
 when making your appointment.
 Upon completion of treatment, we           and NO dental hygiene treatment               important, not only for your smile, but, for
 recommend you also make an                 is provided—fees are as follows:              your heart as well.
 appointment with your family dentist                                                             ( American Dental Association; Cigna Dental)
                                                  Full Mouth Series         $25.00
 for an examination and any dental
 treatment needed.                                Panoramic                 $25.00
                                                  Bitewings                 $15.00
                                                                                          Oral Cancer strikes an estimated 34,360
                                                                                          Americans each year?
   Appointment Times                              Sealants                  $ 6.00 Ea.
                                                                                            On average, only half of those diagnosed
                                                                                          with this disease will live more than 5 years.
   Fall Semester (Sept—Dec)
                                                                                          The best way to prevent oral cancer is to
                                                        Payments                          avoid tobacco and alcohol and have regular
   Mondays and Wednesdays
      8:30 am and 1:00 pm                   Clinic fees are payable on the day            dental examinations.
                                            treatment is initiated. The following are                              (American Cancer Society)
   Monday through Thursday                  accepted forms of payment:
          5:30 pm                                  Cash                 Check                     So...brush, floss and see your
                                                   Master Card           Visa                      dentist hygienist regularly!
   Spring Semester (Jan –Apr)               The clinic does not accept postdated
                                                                                                  You’ll have a healthier life and
                                            checks or provide insurance forms.
     Monday through Thursday                                                                                  smile!
   8:30 am 1 :00 pm 5:30 pm
                                                  Medical Evaluation
                                                                                         The Dental Hygiene Program at the University of Southern Indiana
Call 812-464-1706                           If a client has a medical condition which    is accredited by the Commission on Dental
                                             requires consultation with a physician,
to schedule your                                                                         Accreditation of the American Dental Association, a specialized
                                             treatment may be delayed until written      accrediting body recognized by the Council on
appointment!                                 approval for treatment is received from     Postsecondary Accreditation and by the United States Department
                                             your physician.                             of Education.

				
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