Legal

Terms of Service

Dreamline Dental Sleep Clinic

Effective Date: January 20, 2026

Last Updated: January 20, 2026

Acceptance of Terms

1.1 Agreement to Terms

By accessing our website (www.dreamlinedental.com), using our patient portal, receiving healthcare services, or otherwise engaging with Dreamline Dental Sleep Clinic ("we," "us," "our," or "Practice"), you ("you," "your," or "Patient") accept and agree to be bound by these Terms of Service ("Terms"), along with:

Our Privacy Policy and Notice of Privacy Practices
Patient Portal Terms and Conditions
Any additional service-specific terms or policies
All applicable federal, state, and local laws and regulations

1.2 Capacity to Accept

By accepting these Terms, you represent and warrant that:

You are at least 18 years of age, OR
You are the parent or legal guardian of a minor patient and have authority to accept these Terms on their behalf, OR
You are a legally authorized representative with proper documentation

If you are accepting these Terms on behalf of a minor or incapacitated individual, you agree to be personally bound by these Terms and responsible for the patient's compliance.

1.3 No Agreement, No Service

IF YOU DO NOT AGREE TO THESE TERMS, YOU MAY NOT:

✕Use our website or patient portal
✕Schedule or receive healthcare services
✕Access your or your dependent's health information
✕Communicate with our practice through electronic means

You must discontinue use of all services immediately if you do not agree to these Terms.

1.4 Entire Agreement

These Terms, together with our Privacy Policy and any service-specific agreements, constitute the entire agreement between you and the Practice regarding your use of our services and supersede all prior agreements or understandings.

1.5 Electronic Acceptance

Your electronic acceptance of these Terms (clicking "I Agree," enrolling in the patient portal, or using our services after being provided access to these Terms) constitutes a legally binding agreement equivalent to your physical signature.

Definitions

For purposes of these Terms, the following definitions apply:

"Business Associate"

- A third-party service provider that creates, receives, maintains, or transmits Protected Health Information on behalf of the Practice.

"Healthcare Services" or "Services"

- All clinical and administrative services provided by the Practice, including consultations, examinations, treatments, oral appliance therapy, telehealth visits, and related care.

"HIPAA"

- The Health Insurance Portability and Accountability Act of 1996 and its implementing regulations.

"Patient Portal"

- The secure, web-based application that allows patients to access their health information, communicate with providers, schedule appointments, and manage their healthcare.

"PHI" or "Protected Health Information"

- Individually identifiable health information as defined under HIPAA.

"Practice"

- Dreamline Dental Sleep Clinic, including all providers, employees, contractors, and authorized representatives.

"Telehealth"

- The delivery of healthcare services using electronic communications, video conferencing, or other technology when the patient and provider are in different locations.

"Website"

- www.dreamlinedental.com and all associated web pages, mobile applications, and digital platforms operated by the Practice.

Services Provided

3.1 Scope of Services

Dreamline Dental Sleep Clinic provides comprehensive dental sleep medicine services throughout the state of Missouri, including but not limited to:

Diagnostic Services:

Comprehensive evaluation for sleep-related breathing disorders
Assessment of obstructive sleep apnea (OSA) and snoring
Airway evaluation and analysis
Review of sleep study results (polysomnography, home sleep apnea tests)
Collaboration with sleep physicians and specialists

Treatment Services:

Custom oral appliance therapy for sleep apnea
Mandibular advancement devices (MAD)
Tongue retaining devices
Oral appliance fitting, titration, and adjustments
Combination therapy coordination (oral appliance + CPAP)
Treatment monitoring and follow-up care

Mobile Dental Services:

In-home consultations and examinations
On-site dental impressions and measurements
Oral appliance delivery and fitting at patient location
Follow-up appointments at patient's home or preferred location
Mobile equipment for comprehensive care delivery

Care Coordination:

Collaboration with sleep physicians and referring doctors
Communication with insurance companies for prior authorization
Coordination with dental laboratories for appliance fabrication
Integration with multidisciplinary sleep medicine teams
Ongoing monitoring and adjustment of treatment plans

Supportive Services:

Patient education on sleep disorders and treatment options
Oral appliance care and maintenance instructions
Compliance monitoring and adherence support
Lifestyle and positional therapy recommendations
Long-term follow-up and effectiveness evaluation

3.2 Geographic Service Area

Our mobile services are available throughout the entire state of Missouri. Service areas include, but are not limited to:

Kansas City metropolitan area
St. Louis metropolitan area
Springfield, Columbia, and Jefferson City
Rural and suburban communities statewide

Travel fees may apply for locations outside our primary service area. We will inform you of any additional fees before scheduling.

3.3 Multiple Provider Practice

Our Practice operates with multiple licensed healthcare providers. While you may have a primary treating provider, you acknowledge and agree that:

Other providers may access your health information for treatment, coverage, or quality assurance purposes
In the event of provider absence, another qualified provider may provide care
All providers are bound by the same standards of care and confidentiality obligations
You may request a specific provider, but we cannot always guarantee availability

3.4 Services NOT Provided

The Practice does NOT provide:

✕Emergency dental or medical services (call 911 for emergencies)
✕General dentistry services (cleaning, fillings, extractions, etc.)
✕Sleep studies or polysomnography testing (we coordinate with sleep centers)
✕CPAP equipment or supplies (we coordinate with DME suppliers)
✕Treatment for conditions outside the scope of dental sleep medicine
✕Prescriptions for controlled substances or sleep medications

3.5 Service Modifications

We reserve the right to:

Modify, suspend, or discontinue any service at any time
Update service offerings based on clinical evidence and best practices
Adjust service areas based on operational considerations
Implement new technologies and treatment modalities

Material changes to services will be communicated through our website, patient portal, or direct notification.

Patient Portal Terms

4.1 Portal Purpose and Features

The patient portal is a secure online platform that allows you to:

View your medical and dental records
Access test results and treatment plans
Schedule, reschedule, or cancel appointments
Send and receive secure messages with your care team
Request prescription refills or appliance adjustments
View billing statements and make payments
Update personal and insurance information
Complete intake forms and questionnaires
Download or print health information for personal records

4.2 Portal Registration and Access

Account Creation:

You must create a unique account with username and password
Identity verification required before portal access is granted
Multi-factor authentication strongly recommended and may be required
You may not share your account or credentials with anyone

Account Security:

You are responsible for:

Maintaining the confidentiality of your login credentials
All activities that occur under your account
Notifying us immediately of any unauthorized access or security breach
Using strong, unique passwords (minimum 12 characters with complexity requirements)
Logging out after each session, especially on shared devices

We are NOT responsible for:

Unauthorized access resulting from your failure to protect credentials
Loss or damage resulting from shared account access
Data breaches caused by your device security vulnerabilities

4.3 Proxy Access for Minors and Dependents

Parents/Legal Guardians:

May request proxy access to minor children's (under 18) portal accounts
Must provide proof of parental authority (birth certificate, custody papers)
Access automatically terminates when child reaches age 18
May be restricted for adolescents receiving certain confidential services under Missouri law

Legal Representatives:

Healthcare Power of Attorney holders may request proxy access
Court-appointed guardians must provide court documentation
All proxy users must agree to these Terms and our Privacy Policy

Proxy User Responsibilities:

Maintain confidentiality of patient information
Use information only for patient's benefit
Do not share proxy access credentials
Notify us immediately if proxy access should be revoked

4.4 Portal Communications

Secure Messaging:

Use secure messaging for non-urgent medical questions only
DO NOT use for emergencies - call 911 or our office immediately
We typically respond within 1-2 business days during business hours
Messages sent after hours or on weekends reviewed next business day
All messages become part of your permanent medical record

Prohibited Uses:

Emergency or urgent medical situations
Time-sensitive issues requiring same-day response
Requests for controlled substances or narcotics
Communications unrelated to your healthcare
Spam, marketing, or solicitation

Response Times:

We strive to respond to portal messages within:

1-2 business days for routine questions
Same business day for urgent but non-emergency issues
3-5 business days for complex questions requiring research

No guarantee of response time. For urgent matters, call our office.

4.5 Portal Availability and Technical Issues

Service Availability:

Portal available 24/7/365 except during scheduled maintenance
Planned maintenance typically occurs late night/early morning
Emergency maintenance may occur without advance notice
We are not liable for service interruptions beyond our control

Technical Support:

Portal support available during business hours
Email support for technical issues
Password reset and account recovery available
System requirements and browser compatibility information provided

Your Technical Responsibilities:

Maintain compatible device and updated browser
Ensure reliable internet connection
Install security updates and antivirus software
Use portal only on secure, private networks (not public WiFi)

4.6 Data Security and Privacy

Our Security Measures:

TLS 1.3 encryption for all data transmission
AES-256 encryption for data storage
Multi-layered security architecture
Regular security audits and vulnerability assessments
HIPAA-compliant infrastructure

Your Security Responsibilities:

Do not access portal from public computers or shared devices
Clear browser cache after using portal on shared devices
Enable device security (passwords, biometric locks)
Use secure networks (avoid public WiFi)
Report suspicious activity immediately

Portal Privacy:

All portal activity logged for security and HIPAA compliance
Audit logs maintained for 7 years
No third-party analytics or tracking on authenticated portal pages
See our Privacy Policy for complete information protection details

4.7 Portal Suspension or Termination

We may suspend or terminate your portal access if:

You violate these Terms or our Privacy Policy
You engage in prohibited activities or misuse
You share your account credentials
We suspect unauthorized access or security compromise
Required by law or for legal/regulatory compliance
You request termination of your account

Effect of Termination:

Immediate loss of portal access
You may still access health information through other means (in-person, phone requests)
Does not affect your right to receive healthcare services
Does not relieve you of outstanding payment obligations

4.8 Mobile Application (If Applicable)

If we offer a mobile application:

App subject to these Terms plus app store terms
Push notifications may be enabled (you can disable in settings)
App updates required for continued functionality
App data synced with portal web version
Uninstalling app does not delete your account (must request separately)

Appointments and Scheduling

5.1 Appointment Scheduling

How to Schedule:

Appointments may be scheduled through:

Patient portal (preferred method)
Telephone: (660) 358-1277
Email: info@dreamlinedental.com
In-person at a scheduled visit

Scheduling Requirements:

Appointments must be scheduled in advance (walk-ins not available for mobile service)
New patient appointments require completed intake forms
Mobile service appointments require address and accessibility information
Specific appointment times subject to availability
We will confirm all appointments within 24 hours of request

Appointment Types:

New patient consultation (60-90 minutes)
Follow-up visits (30-45 minutes)
Oral appliance fitting and delivery (45-60 minutes)
Adjustment appointments (15-30 minutes)
Telehealth consultations (30-45 minutes)

5.2 Appointment Confirmation and Reminders

Confirmation:

You will receive appointment confirmation via email, text, or phone call
Confirm or update appointment through patient portal
Provide 24-hour advance notice if you need to reschedule

Reminders:

Automatic reminders sent 48 hours and 24 hours before appointment
Reminder method based on your communication preferences (email, text, phone)
You may opt out of reminders, but you remain responsible for attending scheduled appointments

Mobile Service Preparation:

Ensure location is accessible for our mobile unit
Provide parking information if applicable
Inform us of any access restrictions (gated communities, building security)
Have a suitable space prepared for examination/treatment

5.3 Cancellation and Rescheduling Policy

Advance Notice Required:

Minimum 24 hours notice required for cancellations or rescheduling
Notice must be provided during business hours (business days only)
Weekend/holiday cancellations: must be made by end of business Friday before appointment

How to Cancel or Reschedule:

Patient portal (preferred method - available 24/7)
Phone: (660) 358-1277 during business hours
Email: info@dreamlinedental.com (must be confirmed by staff)

Late Cancellation Fee:

Cancellations made with less than 24 hours notice may be subject to:

$75 late cancellation fee for initial consultations
$50 late cancellation fee for follow-up appointments
Fee charged to your account and due before next appointment can be scheduled

Exceptions:

Late cancellation fees may be waived for:

Medical emergencies (documentation may be required)
Severe weather or natural disasters
Circumstances beyond your reasonable control (determined at our discretion)

5.4 No-Show Policy

No-Show Definition:

A "no-show" occurs when you:

Fail to attend a scheduled appointment
Do not provide any advance notice of cancellation
Are more than 15 minutes late without prior notification

No-Show Consequences:

$100 no-show fee charged for missed initial consultations
$75 no-show fee charged for missed follow-up appointments
Fee must be paid before scheduling future appointments
After two (2) no-shows within a 12-month period:
- Future appointments may require prepayment or credit card on file
- You may be discharged from the practice (see Section 19)

Excessive No-Shows:

After three (3) no-shows within a 12-month period:

We reserve the right to terminate the patient-provider relationship
You will be notified in writing with 30 days to find alternative care
Medical records will be transferred to your new provider upon request

5.5 Late Arrival Policy

Timeliness:

Please arrive 10 minutes early for mobile appointments to allow for preparation
Arriving more than 15 minutes late may be considered a no-show
Late arrivals may result in shortened appointment time or rescheduling

Mobile Service Considerations:

Our schedule is tightly coordinated for multiple mobile visits
Late appointments affect subsequent patients on the route
We may be unable to provide full services if you arrive late
Rescheduling may be necessary if time is insufficient

5.6 Provider Schedule Changes

Our Cancellations:

In rare circumstances, we may need to cancel or reschedule your appointment due to:

Provider illness or emergency
Severe weather or unsafe travel conditions
Equipment malfunction or vehicle issues
Other unforeseen circumstances

If We Cancel:

We will notify you as soon as possible (phone, email, text)
We will work to reschedule at your earliest convenience
No cancellation fee will be charged to you
We apologize for any inconvenience

5.7 Waitlist

Cancellation Waitlist:

You may request to be placed on our cancellation waitlist
We will contact you if earlier appointments become available
You must be able to schedule with short notice (24-48 hours)
No obligation to accept waitlist appointments

Telehealth Services

6.1 Telehealth Service Description

We offer telehealth consultations via secure video conferencing for:

Initial consultations and evaluations
Follow-up appointments and progress checks
Review of sleep study results
Treatment adjustments and care planning
Certain non-emergent consultations
Patient education and counseling

Telehealth is NOT appropriate for:

Emergency medical situations
Comprehensive oral examinations requiring physical inspection
Initial oral appliance fittings and impressions
Conditions requiring hands-on examination or treatment
Situations where in-person care is clinically necessary

6.2 Telehealth Technology Requirements

Patient Requirements: You must have:

Reliable high-speed internet connection (minimum 5 Mbps download/upload)
Computer, tablet, or smartphone with webcam and microphone
Updated web browser or our designated telehealth application
Private, quiet location for the consultation
Adequate lighting for video visibility

Our Platform:

HIPAA-compliant video conferencing platform with end-to-end encryption
No recording of sessions without your explicit consent
Secure authentication and access controls
Technical support available during business hours

6.3 Telehealth Consent and Acknowledgments

By participating in a telehealth appointment, you acknowledge and agree:

Understanding of Telehealth:

Telehealth is different from in-person care and has limitations
Physical examination is limited to what can be observed via video
Technology may fail, resulting in interruptions or poor quality
Telehealth may not be as complete as in-person examination

Patient Location and Emergency Information:

You will provide your physical location for each telehealth visit
You will provide emergency contact information
You understand that if an emergency arises, you should call 911 immediately
We cannot provide emergency services through telehealth

Privacy and Security:

You are in a private, secure location where conversation cannot be overheard
You will not record the session without provider's consent
You understand risks of technology (potential for unauthorized access, though unlikely)
You accept responsibility for securing your location and device

Clinical Limitations:

Some conditions cannot be adequately diagnosed or treated via telehealth
Provider may determine in-person visit is necessary
You may need to be referred for in-person evaluation
Treatment recommendations may be limited without hands-on examination

Technical Issues:

Technical difficulties may require rescheduling
Appointment time may be shortened if technical issues occur
We are not responsible for technology failures beyond our control
Alternative communication methods (phone) may be used if video fails

6.4 Telehealth Appointment Procedures

Before Your Appointment:

Test your equipment and internet connection
Download any required applications
Find a private, well-lit location
Have your insurance card and photo ID ready
Prepare list of questions or concerns
Have any relevant documents or images available to share

During Your Appointment:

Join the appointment on time using provided link
Have camera and microphone enabled
Minimize background noise and distractions
Follow provider's instructions for examination
Ask questions and clarify any concerns

After Your Appointment:

Visit summary and instructions will be sent via patient portal
Prescriptions (if applicable) sent to your pharmacy
Follow-up appointments scheduled as needed
Contact us if you have additional questions

6.5 Telehealth Payment and Insurance

Payment:

Telehealth visits billed at same rate as comparable in-person visits
Payment due at time of service unless insurance is being billed
Co-pays and deductibles apply per your insurance plan

Insurance Coverage:

Many insurers now cover telehealth services
Coverage varies by plan - verify with your insurance before appointment
You are responsible for verifying telehealth coverage
You are responsible for any amounts not covered by insurance

Medicare/Medicaid:

Telehealth coverage expanded but has specific requirements
You must meet eligibility criteria for telehealth reimbursement
We will inform you if your visit qualifies for telehealth coverage

6.6 Telehealth Prescriptions and Referrals

Prescriptions:

Prescriptions may be issued via telehealth for appropriate conditions
Controlled substances generally NOT prescribed via telehealth (DEA regulations)
Prescriptions sent electronically to your pharmacy
Refills may be requested through patient portal

Referrals and Orders:

Referrals to specialists may be provided via telehealth
Orders for sleep studies or diagnostic tests may be issued
Physical equipment or appliances may require in-person visit for fitting

6.7 Telehealth Across State Lines

Missouri Licensure:

Our providers are licensed in Missouri
Services provided to patients located in Missouri
You must be physically located in Missouri during telehealth visit
We cannot provide telehealth services if you are out of state

Verification:

You may be required to confirm your location for each telehealth visit
Providing false location information may result in termination of services

Payment Terms and Financial Policies

7.1 Payment Due at Time of Service

General Policy:

Payment is due at the time of service unless other arrangements made in advance
We accept: credit cards (Visa, MasterCard, Amex, Discover), debit cards, HSA/FSA cards, ACH transfers, cash, and checks
Credit card processing fees may apply for certain payment methods
Returned checks subject to $35 fee plus any bank charges

Payment Methods:

In-person:Payment collected at time of mobile service visit
Patient Portal:Secure online payment for statements and invoices
Phone:Payment by phone during business hours
Mail:Check or money order sent to our billing address

7.2 Fee Schedule and Estimates

Fee Disclosure:

Fee schedule available upon request
We will provide good faith estimate of costs before treatment
Actual costs may vary based on complexity and time required
You will be notified of any significant changes to estimated costs

Additional Fees:

Travel fees for locations outside primary service area
After-hours or weekend appointments (if available)
Rush fabrication or expedited services
Replacement appliances or repairs

Common Services (Subject to Change):

New patient consultation:$[INSERT AMOUNT]

Oral appliance therapy (complete):$[INSERT AMOUNT]

Follow-up adjustment visits:$[INSERT AMOUNT]

Telehealth consultation:$[INSERT AMOUNT]

7.3 Insurance Verification and Pre-Authorization

Patient Responsibility:

You are responsible for understanding your insurance coverage and benefits
You must verify whether services are covered before treatment
You must obtain any required pre-authorizations from your insurance company
Failure to obtain pre-authorization may result in denied claims

Our Assistance:

We will verify insurance eligibility as a courtesy
We will help obtain pre-authorization when possible
We will submit claims to your insurance on your behalf
However, ultimate responsibility for coverage verification rests with you

If Insurance Denies:

You are responsible for full payment if insurance denies coverage
Denied claims must be paid within 30 days of denial notice
You may appeal denials directly with your insurance company
We will provide necessary documentation for appeals

7.4 Medicare and Medicaid

Medicare

We are enrolled Medicare providers. Medicare coverage for oral appliance therapy requires:

Diagnosis of obstructive sleep apnea via sleep study
Documentation of CPAP failure or intolerance (in most cases)
Prior authorization in some circumstances
Medicare patients responsible for deductibles, co-insurance, and non-covered services

MO HealthNet (Medicaid)

We accept Missouri Medicaid (MO HealthNet) for eligible patients
Coverage limited to specific services and criteria
Prior authorization required for most services
Patients must be currently eligible at time of service
We will verify eligibility, but you must maintain active coverage

7.5 Uninsured and Self-Pay Patients

Self-Pay Discount:

Uninsured patients may qualify for self-pay discount (typically 10-20%)
Discount applied if payment made in full at time of service
Payment plans available for large balances (see Section 7.7)

Financial Hardship:

Financial assistance applications available
Income verification required
Decisions made on case-by-case basis
Must apply before services rendered (when possible)

7.6 Billing and Statements

Billing Cycle:

Statements sent monthly for any outstanding balance
Statements available through patient portal (paperless option)
Itemized statements show: date of service, description, charges, payments, insurance adjustments

Payment Due Date:

Payment due within 30 days of statement date
Past due accounts subject to late fees and collection (see Section 7.8)
Contact us immediately if you cannot pay by due date

Billing Questions:

Call Us:

(660) 358-1277

Email Us:

info@dreamlinedental.com

Billing questions addressed within 5 business days.

7.7 Payment Plans

Eligibility:

• Payment plans available for balances over $500
• Credit check may be required
• Must have no outstanding past due balances with our practice

Terms:

• Maximum 12-month payment period
• Minimum monthly payment: $100
• Interest-free if paid as agreed
• Automatic payment (ACH or credit card) required
• Missed payment may result in plan cancellation and full balance due

Application:

• Complete application through patient portal or billing office
• Approval within 3-5 business days
• First payment due upon approval

7.8 Past Due Accounts and Collections

Late Fees:

30+ Days Past Due$25 Late Fee
60+ Days Past Due$50 Total
Late fees added monthly until balance paid in full

Collection Process:

30 Days Past Due:

First reminder notice sent. Late fee applied. Phone call or email contact attempt.

60 Days Past Due:

Second notice sent. Additional late fee applied. Services may be suspended until account current.

90 Days Past Due:

Final notice before collection referral. Account may be referred to external collection agency and reported to credit bureaus.

Collection Agency Referral

• Account referred to third-party collection agency
• Collection agency may report to credit bureaus
• You remain responsible for balance plus collection costs (up to 33%)
• Patient-provider relationship may be terminated

7.9 Refunds and Overpayments

Insurance Overpayments:

• Refunded within 30 days
• Refund via original payment method or check
• May be applied to outstanding balance with your consent

Treatment Refunds:

• Canceled treatment refunds processed within 30 days
• Deposits for services not yet rendered may be refunded (minus fees)
• No refunds for completed services

Credit Balances:

• Under $25 may be held as credit for future services
• Over $25 refunded within 60 days
• You may request refund of any credit balance at any time

Insurance and Third-Party Payments

8.1 Insurance Participation

Accepted Insurance:

We participate with most major insurance carriers including:

Medicare (Parts B, C)

Medicaid (MO HealthNet)

Blue Cross Blue Shield

United Healthcare

Cigna

Aetna

Humana

[Additional carriers - contact office to verify]

Non-Participating Plans:

For out-of-network plans, we will provide a superbill for you to submit
You are responsible for full payment at time of service
Your insurance may reimburse you directly based on your out-of-network benefits

8.2 Assignment of Benefits

By signing this agreement or receiving services, you:

Assign all insurance benefits directly to the Practice
Authorize us to bill insurance on your behalf
Authorize your insurance to pay us directly
Agree to pay any amounts not covered by insurance

8.3 Coordination of Benefits

Multiple Insurance Plans:

If you have multiple insurance policies, you must inform us
Primary insurance must be billed first
Secondary insurance billed after primary processes claim
You are responsible for any remaining balance

Medicare Secondary Payer:

You must inform us if you have other insurance in addition to Medicare
We are required to bill primary insurance first per CMS regulations
Failure to provide accurate insurance information may result in claim delays

8.4 Insurance Claims Submission

Our Commitment:

We will submit claims to your insurance as a courtesy
Claims submitted electronically within 7 business days of service
We will provide necessary documentation to support medical necessity
We will respond to insurance requests for additional information

Your Responsibility:

Provide accurate, current insurance information
Update insurance information when changes occur
Obtain required pre-authorizations
Pay any amounts insurance does not cover
Appeal claim denials with your insurance if desired

Claim Denials:

We will notify you of denied claims
You are responsible for payment of denied claims
We will provide documentation for appeals

We are NOT responsible for denied claims due to:

×Lack of pre-authorization
×Lapsed insurance coverage
×Services not covered under your plan
×Inaccurate information provided

8.5 Insurance Appeals

Our Assistance:

We will provide medical records and documentation for appeals
We will respond to insurance company requests for peer-to-peer review
We will submit corrected claims if errors identified

Your Responsibility:

You must initiate appeals with your insurance
You must follow insurance company appeals process and timelines
You remain responsible for payment while appeal is pending

8.6 Workers' Compensation and Auto Accident Claims

Workers' Compensation:

We accept workers' compensation for work-related sleep disorders
Pre-authorization from employer/insurer required before services
You must provide claim number and adjuster contact information
You are responsible if claim is denied or not work-related

Motor Vehicle Accidents:

We may bill auto insurance for accident-related injuries
Attorney lien or letter of protection may be required
Medical payments or PIP coverage billed first
You are responsible for balance if auto insurance does not cover

8.7 Out-of-Pocket Maximums and Deductibles

Understanding Your Costs:

You are responsible for deductibles, co-pays, and co-insurance
Amounts applied to your out-of-pocket maximum based on your plan
Contact your insurance for explanation of benefits

FRAUD PREVENTION NOTICE

We cannot waive co-pays or deductibles (this is insurance fraud).

Patient Responsibilities

9.1 Accurate Information

You are responsible for providing:

Complete and accurate personal and contact information
Accurate medical and dental history
Current medication lists and allergies
Insurance information and changes to coverage
Emergency contact information
Updated address, phone, and email

False Information:

Providing false or misleading information may result in:

Denial of services
Claim denials and responsibility for full payment
Termination of patient-provider relationship
Potential legal consequences

9.2 Medical History and Health Changes

Initial Information:

Complete all intake forms thoroughly and honestly
Disclose all medical conditions and previous treatments
Provide copies of recent sleep studies or diagnostic tests
List all medications, supplements, and allergies

Updates:

Inform us of any changes to your health status
Report new diagnoses or medical conditions
Update medication lists at each visit
Report adverse reactions or side effects immediately

Failure to Disclose:

Failure to disclose relevant medical information may:

Compromise your treatment outcomes
Result in inappropriate or ineffective treatment
Create safety risks
Void any guarantees or warranties on treatment

9.3 Treatment Compliance

Following Treatment Plans:

You agree to:

Follow prescribed treatment plans and instructions
Use oral appliances as directed by your provider
Attend all scheduled follow-up appointments
Complete recommended sleep studies or diagnostic tests
Maintain oral appliances properly per care instructions
Report any problems, discomfort, or concerns promptly

Non-Compliance Consequences:

✕
Treatment may be ineffective if not followed as prescribed
✕
Provider may be unable to continue treatment if you are non-compliant
✕
Insurance may deny coverage for follow-up care if treatment not used
✕
We may discharge you from the practice for persistent non-compliance

9.4 Medication and Substance Disclosure

Full Disclosure Required:

You must inform us of:

All prescription medications (including dosages)
Over-the-counter medications and supplements
Recreational drug use (marijuana, etc.)
Alcohol consumption
Tobacco or nicotine use
Any changes to medications or substance use

Confidentiality:

• Information you provide is confidential and protected under HIPAA
• We need this information to provide safe, effective treatment
• Will not be disclosed to third parties without your authorization (except as required by law)

9.5 Appointment Attendance

You are responsible for:

Attending all scheduled appointments on time
Providing 24-hour notice for cancellations
Rescheduling missed appointments
Paying cancellation or no-show fees as applicable

9.6 Payment Obligations

You agree to:

Pay all amounts due at time of service
Pay any balances not covered by insurance
Make payment arrangements for large balances
Keep payment methods current and valid
Notify us of billing disputes within 30 days

9.7 Communication and Responsiveness

You are responsible for:

Responding to appointment reminders and confirmations
Checking patient portal for messages and test results
Returning phone calls and emails within reasonable timeframe
Keeping contact information current
Notifying us if you do not receive expected communications

"Accurate and timely communication is essential for your safety and treatment success."

9.8 Oral Appliance Care and Maintenance

Daily Care:

• Clean oral appliance daily per provided instructions
• Store appliance properly when not in use
• Inspect appliance regularly for damage or wear
• Do not attempt to adjust or modify appliance yourself

Protection:

• Protect appliance from heat, pets, and children
• Bring appliance to all follow-up appointments
• Do not use appliance if damaged (contact office immediately)

Replacement:

• Lost or damaged appliances are your financial responsibility
• Replacement fees apply for lost, damaged, or pet-damaged appliances
• Some insurance plans cover replacement after certain time period

9.9 Record Retention

You have the right to copies of your medical records
We recommend maintaining personal copies of important documents

Records retained per Missouri law (7 years minimum)
You are responsible for requesting records before retention period expires

Treatment and Medical Advice

10.1 Standard of Care

Professional Standards:

Reasonable care and skill consistent with accepted professional standards
Evidence-based treatment approaches
Ongoing professional education and training
Compliance with all applicable laws and regulations

No Guarantees:

We do NOT guarantee:

Specific treatment outcomes or results
Complete resolution of sleep disorder symptoms
Tolerance or acceptance of oral appliance therapy
Insurance coverage or reimbursement for services

10.2 Treatment Effectiveness and Variables

Individual Results:

Treatment effectiveness varies based on:

Severity of sleep-disordered breathing
Patient anatomy and physiology
Compliance with treatment recommendations
Concurrent medical conditions
Lifestyle factors (weight, alcohol use, sleep position)
Individual tolerance and adaptation

Success Factors:

Treatment success depends on:

Proper diagnosis and appliance selection
Accurate fitting and titration
Consistent nightly use of oral appliance
Regular follow-up and adjustment
Coordination with sleep physician
Management of contributing factors

10.3 Alternative Treatments

Informed Consent:

We will discuss alternative treatment options including:

Continuous Positive Airway Pressure (CPAP) therapy
Surgical interventions
Positional therapy
Weight loss and lifestyle modifications
Combination therapies

Patient Choice:

You have the right to choose your treatment approach
You may decline recommended treatment
You may seek second opinions
Treatment decisions are made jointly between you and your provider

10.4 Limitations of Dental Sleep Medicine

Scope of Practice:

We treat sleep-disordered breathing within the scope of dental sleep medicine
We do NOT diagnose sleep disorders (diagnosis by sleep physician)
We do NOT treat other sleep disorders (insomnia, narcolepsy, etc.)
We coordinate with sleep physicians for comprehensive care

Referrals:

We will refer you to appropriate specialists when:

Conditions outside our scope of practice are identified
Medical evaluation or treatment is needed
Surgical consultation is appropriate
Other sleep disorders are suspected

10.5 Risks and Complications

Oral Appliance Therapy Risks:

Temporary jaw discomfort or soreness

Excessive salivation or dry mouth

Tooth discomfort or sensitivity

Changes in bite or tooth position (rare but possible)

TMJ symptoms

Appliance damage or breakage

Allergic reaction to materials (very rare)

Reporting Issues:

You must report immediately:

✕Severe or persistent pain
✕Significant tooth movement
✕Broken or damaged appliance
✕Allergic reactions
✕TMJ symptoms that worsen
✕Any concerns about treatment

Risk Management:

We minimize risks through:

Thorough initial evaluation
Proper appliance selection and fitting
Regular follow-up monitoring
Patient education and instruction
Prompt response to patient concerns

10.6 Emergency Situations

Medical Emergencies:

Call 911 immediately for medical emergencies
Do NOT use patient portal or email for emergencies
After-hours emergencies: call emergency services first, then contact our office

Dental Emergencies:

Contact our office during business hours for dental concerns
After-hours dental issues: leave message for callback or seek urgent care
If appliance causes severe pain, remove it and contact us next business day

10.7 Website Medical Information

Educational Purpose Only:

• Information on our website is for educational purposes only
• Website content does NOT constitute medical advice
• Do not rely solely on website information for treatment decisions
• Always consult with a qualified healthcare provider

No Patient-Provider Relationship:

Viewing our website does not create a patient-provider relationship
Patient-provider relationship established only when you receive services
Website information is general and not specific to your condition

10.8 Coordination with Other Providers

Team-Based Care:

Dental sleep medicine often requires coordination with multiple providers
We will communicate with your sleep physician, dentist, and other providers (with your authorization)
You are responsible for keeping all providers informed
Follow recommendations from all members of your care team

Records Sharing:

• We may share records with other providers involved in your care
• Authorization required for non-treatment disclosures
• See our Privacy Policy for complete information sharing details

Electronic Communications and Consent

11.1 Email Communications

Permitted Uses:

We may send email for:

Appointment reminders and confirmations
General practice announcements
Educational information
Billing statements (if you opt in)
Administrative communications

Limitations:

Email is NOT secure and may be intercepted
✕
Do NOT send sensitive medical information via regular email
Use patient portal secure messaging for medical questions
Do NOT use email for urgent or emergency matters

Your Consent:

By providing your email address, you:

Consent to receive appointment reminders via email

Acknowledge email is not completely secure

Accept risks of email communication

May opt out at any time

11.2 SMS Text Messaging

Text Message Services:

We may send text messages for:

Appointment reminders
Appointment confirmations
Practice announcements
Two-factor authentication codes

Consent and Opt-In:

• You must affirmatively opt in to receive text messages
• Standard text messaging rates apply (check with your carrier)
• Reply "STOP" to opt out at any time
• Reply "HELP" for assistance

Limitations:

×
Text messages contain limited information only
×
Do NOT reply to automated text messages with medical questions
×
Text messaging is NOT secure
×
Use patient portal for medical communications

11.3 Telephone Communications

Voicemail Messages:

• We may leave voicemail messages with appointment reminders
• Messages contain minimal information (date, time, callback number)
• We do NOT leave detailed medical information unless you specifically authorize

Recording:

• Phone calls may be recorded for quality assurance and training
• You will be notified if call is being recorded
• You may decline to be recorded

Your Preferences:

You may specify:

Which phone number(s) to call (home, mobile, work)
Whether we can leave voicemail
What information can be included in messages
Preferred contact times

11.4 Preferred Communication Method

Patient portal secure messaging is the preferred method for non-urgent medical questions.

Messages encrypted and HIPAA-compliant
Messages become part of your medical record
Typical response within 1-2 business days

11.5 Electronic Consent Management

Consent Records:

• All electronic consents documented in your medical record
• You may review your consent preferences in patient portal
• You may revoke consent at any time (does not affect prior communications)

Communication Preferences:

Update your preferences for:

Email communications (on/off)
Text message reminders (on/off)
Phone call reminders (on/off)
Voicemail permissions (yes/no)
Preferred contact method

Privacy and Confidentiality

12.1 HIPAA Compliance

We comply with all requirements of the Health Insurance Portability and Accountability Act (HIPAA) and protect your health information as required by law.

Privacy Policy:

Our complete privacy practices are described in our Notice of Privacy Practices and Privacy Policy, which is incorporated by reference into these Terms.

Your Privacy Rights:

Please review our Privacy Policy for complete information about:

What information we collect
How we use and disclose your information
Your rights regarding your health information
How to file privacy complaints
Our security measures

12.2 Confidentiality Obligations

Our Obligations:

Maintain confidentiality of all patient communications and records
Implement appropriate safeguards to protect your information
Limit access to your information on a need-to-know basis
Train all workforce members on privacy and security requirements

12.3 Patient Portal Privacy

See Section 4.6 for complete patient portal privacy and security terms.

Permitted Disclosures:

We may use or disclose your information without authorization for:

Treatment, payment, and healthcare operations
As required or permitted by law
As described in our Privacy Policy

Prohibited Disclosures:

We will NOT:

✕
Sell your health information
✕
Use your information for marketing without your authorization
✕
Disclose your information to third parties without authorization (except as permitted by law)

12.4 Business Associates

We work with third-party service providers ("Business Associates") who may access your protected health information to help us provide services. All Business Associates:

Sign HIPAA-compliant Business Associate Agreements
Are required to protect your information with appropriate safeguards
May use information only for specified purposes
Must report security incidents and breaches

12.5 Breach Notification

In the unlikely event of a breach of your protected health information, we will notify you within 60 days of discovering the breach.

Notification will explain what happened and steps you should take. We will take corrective action to prevent future breaches.

See our Privacy Policy Section 15 for complete breach notification procedures.

View our full Privacy Policy for detailed information on your rights.

Website Use and Acceptable Use Policy

13.1 Website Purpose

Our website (www.dreamlinedental.com) provides:

Information about our services and providers
Educational resources about sleep disorders and treatment
Access to patient portal
Online appointment scheduling
Contact information and office hours

13.2 Acceptable Use

Permitted Uses:

You may use our website to:

Learn about our services and providers
Access educational information
Schedule appointments
Access your patient portal account
Contact our office

Prohibited Uses:

You may NOT:

×Use our website for any unlawful purpose
×Attempt to gain unauthorized access to systems or accounts
×Transmit viruses, malware, or harmful code
×Scrape, copy, or harvest data from our website
×Interfere with website operation or security
×Impersonate another person or entity
×Use automated systems (bots, scrapers) to access the website
×Violate any applicable laws or regulations

13.3 User Accounts and Security

Account Security:

You are responsible for maintaining the security of your account credentials
Do not share passwords or login information
Notify us immediately of any unauthorized access
We are not liable for losses from unauthorized access due to your failure to protect credentials

Prohibited Account Activities:

✕
Creating multiple accounts
✕
Allow others to use your account
✕
Providing false information during registration
✕
Using another person's account without permission

13.4 Intellectual Property Rights

Our Content:

All website content is owned by Dreamline Dental Sleep Clinic or our licensors, including text, graphics, logos, images, videos, software, and other materials. Content is protected by copyright, trademark, and other laws.

Your Limited License:

You may:

• View and download content for personal, non-commercial use only
• Print single copies of pages for personal reference

You may NOT:

• Reproduce, distribute, or publicly display our content
• Modify, adapt, or create derivative works
• Use content for commercial purposes
• Remove copyright or proprietary notices

13.5 User-Generated Content

Patient Portal Content:

• Information you provide through patient portal (messages, forms) becomes part of your medical record
• You grant us a license to use this information for treatment, payment, and healthcare operations
• You represent that information you provide is accurate and does not violate others' rights

Testimonials and Reviews:

If you provide testimonials or reviews, you grant us permission to use them on our website
We may edit testimonials for length or clarity
We will not use your name without permission

13.6 Third-Party Links and Services

External Links:

Our website may contain links to third-party websites
We are NOT responsible for content, privacy practices, or terms of external sites
External links provided for convenience only
We do not endorse third-party sites or products

Third-Party Services:

• Features may use third-party services (scheduling, payment)
• Use of third-party services subject to their terms and privacy policies
• We use only HIPAA-compliant services for protected health information

13.7 Website Availability

• Website available 24/7 except during maintenance
• We may suspend website temporarily for updates or maintenance
• We are not liable for downtime or unavailability

Modifications

We reserve the right to:

Modify, suspend, or discontinue any website feature at any time
Update website design, content, or functionality
Implement new features or remove existing features
Make changes without prior notice

13.8 Monitoring and Enforcement

Monitoring:

• We may monitor website use for security and compliance purposes
• We log access and activities for security monitoring
• Monitoring does NOT create any obligation to intervene in user activities

Enforcement:

We may:

×
Suspend or terminate your website access for violations
×
Remove user-generated content that violates these Terms
×
Report illegal activities to law enforcement
×
Take legal action for serious violations

Intellectual Property

14.1 Ownership of Content

Practice-Owned Content: All content on our website, patient portal, and in our communications is owned by or licensed to Dreamline Dental Sleep Clinic, including:

Website design and layout

Text, graphics, photographs, and images

Logos, trademarks, and service marks

Software and applications

Educational materials and resources

Treatment protocols and clinical documentation

14.2 Trademarks

Our Marks:

"Dreamline Dental Sleep Clinic," "Dreamline Dental," our logo, and other marks are trademarks or service marks of our Practice.

Prohibited Uses:

You may NOT:

×Use our trademarks without written permission
×Use marks in a way that causes confusion
×Create derivative marks or similar marks
×Register domain names using our marks

14.3 Copyright

Fair Use:

Limited use may be permitted under fair use doctrine for:

Personal, non-commercial use
Educational purposes (with attribution)
News reporting or commentary

Permission Requests:

For permissions beyond fair use, contact:

info@dreamlinedental.com

14.4 DMCA Compliance

Copyright Infringement:

If you believe content on our website infringes your copyright:

Send written notice to our designated DMCA agent
Include: identification of copyrighted work, infringing material location, your contact information, good faith statement
We will investigate and respond per DMCA procedures

DMCA Agent:

(660) 358-1277

14.5 Patient Records and Data

Your Medical Records:

Medical records are owned by the Practice
You have the right to access and obtain copies
You may not reproduce or distribute records for commercial purposes
Records protected under HIPAA and state law

Your Personal Data:

You retain ownership of personal information you provide
By providing information, you grant us license to use it for healthcare purposes
See Privacy Policy for complete data use terms

Mobile Service Specific Terms

15.1 Service Delivery Model

Mobile Dental Unit:

We provide services using a fully-equipped mobile dental unit
Mobile unit brings necessary equipment and supplies to your location
Services delivered at your home, workplace, or other agreed location

Limitations:

Some services may require in-office or laboratory setting
Complex procedures may necessitate referral to traditional facility
Equipment limitations may affect available services

15.2 Location Requirements

Accessible Locations:

Your location must:

Have adequate parking or access for our mobile unit
Provide sufficient space for equipment setup
Have electrical power access (if needed)
Be accessible without unusual obstacles or hazards
Have climate-controlled space for patient comfort

You Must Provide:

Accurate address and detailed directions
Parking information and any access codes
Notice of any access restrictions (gates, security)
Alternative parking options if primary location unavailable
Notification of any hazards or access challenges

15.3 Service Area and Travel

Coverage Area:

We serve the entire state of Missouri
Primary service areas: Kansas City, St. Louis, Columbia, Springfield metro areas
Rural and suburban locations throughout Missouri

Travel Fees:

May apply for locations outside primary service area
Calculated based on distance and travel time
Disclosed in advance before appointment confirmation
Must be paid at time of service

Weather and Safety:

Severe weather may necessitate rescheduling
We prioritize safety of patients and staff
Alternative arrangements made when travel is unsafe

15.4 Mobile Unit Safety and Maintenance

Equipment Standards:

Mobile unit equipped with professional-grade dental equipment
Regular maintenance and safety inspections
Compliance with all applicable health and safety regulations
Sterilization and infection control per CDC and ADA guidelines

Infection Control:

Same infection control standards as traditional dental office
Sterilization of instruments between patients
Single-use disposable items when appropriate
Personal protective equipment (PPE) for all procedures

15.5 Home Visit Etiquette

Respectful Service: We will:

Arrive within scheduled appointment window
Respect your property and privacy
Minimize disruption to your home or workplace
Clean up after service completion
Remove all waste and materials

Your Cooperation: Please:

Provide clear space for equipment setup
Secure pets during appointment
Minimize distractions and noise
Have treatment area ready before arrival
Notify us of any household hazards

15.6 Cancellations Due to Location Issues

Location-Related Cancellations:

If we cannot access your location due to:

×
Inaccurate address or directions
×
Unsafe access conditions
×
Inadequate parking or space
×
Unforeseen obstacles or hazards

Consequences:

Appointment may need to be rescheduled
May be considered late cancellation or no-show
Fees may apply if issue was not disclosed in advance
Alternative location may be arranged

Limitation of Liability and Disclaimers

16.1 Healthcare Services Disclaimer

No Guarantee of Results:

We provide dental sleep medicine services with reasonable care and skill consistent with professional standards, but we do NOT guarantee:

Specific treatment outcomes or results
Complete resolution of sleep disorder symptoms
Tolerance or acceptance of oral appliance therapy
Prevention of disease progression
Compatibility with all patients

16.2 Individual Variability

Treatment Results Vary:

Treatment effectiveness depends on factors beyond our control, including:

Individual patient anatomy and physiology
Severity and nature of sleep disorder
Patient compliance with treatment recommendations
Concurrent medical conditions and medications
Lifestyle factors (weight, alcohol, sleep habits)
Genetic and biological factors

No Warranties:

We make no express or implied warranties regarding:

✕Fitness for particular purpose
✕Merchantability of services or products
✕Results or outcomes of treatment
✕Error-free or uninterrupted services

16.3 Limitation of Liability

Maximum Liability:

To the fullest extent permitted by Missouri law, our total liability to you for any claims arising from or related to services provided shall not exceed the amount you actually paid us for services during the 12 months preceding the claim.

Excluded Damages:

We are NOT liable for:

✕Indirect, incidental, consequential, or punitive damages
✕Lost profits or business opportunities
✕Emotional distress (except where legally required)
✕Third-party claims
✕Damages resulting from your failure to follow instructions
✕Damages caused by factors beyond our reasonable control

Exceptions:

This limitation does not apply to:

Gross negligence or willful misconduct
Violations of patient rights under HIPAA
Cases where limitation prohibited by law

16.4 Website and Technology Disclaimers

"As Is" Basis:

Our website, patient portal, and technology services are provided "as is" without warranties of any kind, express or implied.

No Warranty:

We do NOT warrant that:

✕Website or portal will be uninterrupted or error-free
✕Defects will be corrected
✕Services are free from viruses or harmful components
✕Information is accurate, complete, or current
✕Technology will meet your specific requirements

Technology Risks:

You acknowledge and accept risks of:

System failures or downtime
Data transmission errors
Security breaches despite our safeguards
Third-party service failures
Internet connectivity issues

16.5 Third-Party Services

Not Responsible for Third Parties:

✕Actions or omissions of third-party service providers
✕Sleep studies or tests performed by third parties
✕Dental laboratories or equipment manufacturers
✕Insurance company decisions or denials
✕Pharmacy errors or medication issues
✕Referral providers' care or services

Business Associates:

While our Business Associates sign HIPAA-compliant agreements, we are not liable for their independent actions, data breaches, or failures beyond our control.

16.6 Force Majeure

Events Beyond Our Control:

We are not liable for failure to perform services due to:

Acts of God (natural disasters, severe weather)
Pandemic or epidemic
Government orders or regulations
Labor disputes or strikes
Equipment failure or shortage
Transportation disruptions
Other circumstances beyond our reasonable control

Effect:

Performance obligations suspended during force majeure event. We will make reasonable efforts to resume services as soon as practicable.

16.7 Professional Judgment

Clinical Decisions:

Treatment recommendations are based on professional judgment, clinical evidence, and individual patient factors. We are not liable for:

✕Disagreement with treatment approaches
✕Alternative treatment preferences
✕Outcome differences from patient expectations
✕Individual responses to treatment

Scope of Practice:

We practice within the scope of dental sleep medicine. We are not responsible for:

✕Diagnosis or treatment of conditions outside our specialty
✕Medical care by other providers
✕Comprehensive sleep medicine management
✕Conditions we refer to specialists

Indemnification

17.1 Patient Indemnification

You agree to indemnify, defend, and hold harmless Dreamline Dental Sleep Clinic, its providers, employees, contractors, and agents from and against any and all claims, damages, losses, liabilities, costs, and expenses (including reasonable attorneys' fees) arising from or related to:

Your Conduct:

Your violation of these Terms of Service
Your violation of any applicable laws or regulations
Your breach of representations or warranties made herein
Your negligence or willful misconduct

Information You Provide:

Inaccurate or false information you provide
Your failure to update information
Misrepresentation of insurance coverage or eligibility
Fraudulent activity or identity theft

Third-Party Claims:

Claims by third parties based on your actions
Unauthorized use of another person's information
Violation of third-party intellectual property rights
Defamatory or harmful communications you make

Portal and Website Misuse:

Unauthorized access to systems or accounts
Transmission of harmful code or malware
Violation of acceptable use policies
Interference with services or other users

17.2 Scope of Indemnification

Coverage:

Indemnification includes:

Legal fees and costs of defense
Settlement amounts (with our approval)
Judgments and awards
Investigation costs

Procedure:

We will notify you of claims requiring indemnification
We reserve the right to control defense with counsel of our choice
You must cooperate with defense efforts
You may not settle claims without our written consent

17.3 Exceptions

You are NOT required to indemnify for:

Our negligence or willful misconduct
Our violation of HIPAA or privacy laws
Claims arising solely from our breach of these Terms
Matters where indemnification prohibited by law

Dispute Resolution and Arbitration

18.1 Informal Resolution

Mandatory First Step:

Before initiating formal proceedings, you agree to:

Contact us in writing describing the dispute
Provide at least 30 days for us to attempt resolution
Participate in good faith discussions to resolve the matter
Escalate to Privacy Officer or Practice Administrator if needed

Contact for Disputes:

Email:

info@dreamlinedental.com

Phone:

(660) 358-1277

Attn: Dispute Resolution

18.2 Binding Arbitration Agreement

Agreement to Arbitrate:

Except as specified below, any dispute, claim, or controversy arising from or relating to these Terms, your use of our services, or our patient-provider relationship shall be resolved by binding arbitration rather than in court.

Arbitration Rules:

Arbitration conducted under rules of the American Arbitration Association (AAA)
Healthcare Disputes Rules apply (if available)
One arbitrator selected per AAA procedures
Arbitration held in Missouri (location determined by arbitrator)

Arbitration Process:

Each party pays own attorneys' fees unless arbitrator awards fees
Discovery permitted as needed, subject to arbitrator discretion
Arbitrator's decision is final and binding
Limited appeal rights per Federal Arbitration Act
Judgment may be entered in any court of competent jurisdiction

18.3 Exceptions to Arbitration

Court Actions Permitted:

The following may be brought in court (not arbitration):

Small claims court actions (if within jurisdictional limits)
Emergency injunctive or equitable relief
Collection actions for unpaid bills
HIPAA privacy complaints (filed with HHS)
Medical malpractice claims (per Missouri law)

Malpractice Exception:

Medical malpractice claims arising from professional negligence in the provision of healthcare services are NOT subject to arbitration and may be filed in court per Missouri law.

18.4 Class Action Waiver

No Class Actions:

You agree that:

✕Disputes will be resolved on an individual basis only
✕You waive the right to participate in class action lawsuits
✕You waive the right to serve as class representative
✕You may not consolidate claims with other patients
✕Arbitrator may not consolidate claims without all parties' consent

If Class Action Waiver Invalid:

If class action waiver found unenforceable, the entire arbitration agreement is void and disputes will be resolved in court.

18.5 Opt-Out of Arbitration

Right to Opt Out:

You may opt out of the arbitration agreement by:

Sending written notice within 30 days of accepting these Terms
Mailing to: [INSERT PRACTICE ADDRESS]
Attn: Arbitration Opt-Out
Include: your name, address, and statement opting out of arbitration

Effect of Opt-Out:

You retain right to pursue claims in court
We retain right to pursue claims against you in court
Does not affect other Terms of Service

18.6 Modification of Arbitration Terms

Future Changes:

Changes to arbitration provisions do not apply to disputes that arose before the change.

You may reject changes to arbitration terms by opting out within 30 days of notice.

Termination of Services

19.1 Termination by Patient

Your Right to Terminate:

You may terminate the patient-provider relationship at any time by:

Providing written notice to our office
Requesting transfer of medical records to new provider
No termination fee or penalty

Your Obligations Continue:

Termination does not relieve you of:

Outstanding payment obligations
Responsibility for services already provided
Confidentiality obligations
These Terms of Service (for past services)

19.2 Termination by Practice

We may terminate the patient-provider relationship for:

Non-Payment:

Failure to pay outstanding balance after 90 days
Multiple returned checks or declined payments
Failure to comply with payment plan

Non-Compliance:

Failure to follow prescribed treatment plans
Repeated missed appointments (3+ no-shows)
Failure to attend required follow-up visits
Non-cooperation with care coordination

Disruptive Behavior:

Abusive, threatening, or harassing conduct toward staff or providers
Violation of office policies or procedures
Illegal activity or fraud
Breach of these Terms of Service

Safety Concerns:

Behavior that threatens safety of staff, providers, or other patients
Situations where we cannot provide safe care

Other Reasons:

Loss of insurance participation
Provider retirement or practice closure
Relocation outside service area
Conflict of interest

19.3 Termination Procedures

Notice Requirements:

We will provide 30 days written notice before termination (except emergency situations)
Notice sent via certified mail to last known address
Notice includes: reason for termination, effective date, instructions for records transfer

Emergency Termination:

• Immediate termination permitted for serious safety threats
• Notice provided as soon as practicable
• Emergency care provided until transfer arranged

Medical Records Transfer:

We will provide copies of medical records to new provider
You are responsible for designating new provider
Records transfer per your written authorization
Reasonable copying fees may apply

19.4 Continuity of Care

Ongoing Care During Transition:

We will provide care for 30 days after termination notice (except emergency termination):

• Emergency services not guaranteed
• Limited to existing treatment only (no new treatment plans)
• Helps ensure smooth transition to new provider

Assistance with Transition:

We will provide referrals to other providers (if requested)
We will communicate with new provider (with your authorization)
We will provide necessary documentation for transition

19.5 Post-Termination Rights and Obligations

Your Rights & Obligations:

Rights:
• Access to medical records (per HIPAA)
• Copies of records for new provider
• Outstanding credit balances refunded

Obligations:
• Pay all outstanding balances
• Return any practice property (loaner equipment, etc.)
• Do not use patient portal after termination (access will be revoked)

Our Obligations:

Maintain medical records per retention requirements
Protect your health information per HIPAA
Respond to records requests
Refund any overpayments or credit balances

Modifications to Terms

20.1 Right to Modify

We reserve the right to modify, update, or replace these Terms of Service at any time for any reason, including:

Changes in applicable laws or regulations

Updates to service offerings or business practices

Enhancements to patient portal or technology

Clarifications or corrections

Response to legal or compliance requirements

20.2 Notice of Changes

How We Notify:

Material changes will be communicated through:

Notice on our website with updated "Last Updated" date
Email to address on file (if significant changes)
Patient portal notification
Notice at your next appointment
Posting in our office or mobile unit

Effective Date:

Changes effective immediately upon posting unless otherwise stated
May specify future effective date for material changes
Will provide reasonable notice for significant changes

20.3 Your Acceptance of Changes

Continuing Use:

Your continued use of our services or website after changes constitutes acceptance of modified Terms.

Objection to Changes:

• Discontinue use of services
• Terminate provider relationship
• Contact us to discuss concerns
• Prior Terms govern past services

Material Changes:

• Prominent notice provided
• Opportunity to review changes
• Continued use = acceptance

20.4 Version History:

• Archive of previous Terms maintained
• Available upon request for reference
• Previous versions govern past services

20.5 General Provisions

No Waiver:

Our failure to enforce any provision of these Terms does not constitute waiver of that provision or our right to enforce it in the future.

Severability:

If any provision is found invalid or unenforceable, the remaining provisions remain in full effect.

Governing Law and Jurisdiction

21.1 Governing Law

Missouri Law:

These Terms of Service are governed by and construed in accordance with the laws of the State of Missouri, without regard to its conflict of law provisions.

Federal Law:

Where applicable, federal law governs, including:

• HIPAA
• ADA
• FDCPA
• Healthcare Federal Laws

21.2 Jurisdiction and Venue

For disputes not subject to arbitration:

• Exclusive jurisdiction in state or federal courts in Missouri
• Venue in county of services or Practice location
• Consent to personal jurisdiction in Missouri courts

Service of Process:

Dreamline Dental Sleep Clinic

St. Louis, Kansas City, Springfield, Columbia & all of Missouri

Attn: Legal Department

21.3 Missouri-Specific Provisions

State Regulations:

We comply with Missouri state regulations including:

Missouri Dental Practice Act
Missouri health info privacy laws (Mo. Rev. Stat. § 191.227)
Missouri data breach notification law (Mo. Rev. Stat. § 407.1500)
Missouri consumer protection laws

Professional Licensing:

Providers licensed by Missouri Dental Board
Services per Missouri scope of practice laws
Continuing education per Missouri requirements

Severability

22.1 Severability Clause

If any provision of these Terms of Service is found to be invalid, illegal, or unenforceable by a court of competent jurisdiction or arbitrator:

Remaining Terms:

All other provisions remain in full force and effect
Invalid provision will be reformed to extent possible to achieve intent
Remaining Terms continue to bind the parties

Reformation:

Court or arbitrator may modify invalid provision to make it enforceable
Modified provision should reflect our original intent as closely as possible
If reformation not possible, provision will be severed

22.2 Essential Terms

If a court or arbitrator finds that any of the following essential provisions are invalid or unenforceable, we may elect to terminate these Terms:

Payment obligations

Limitation of liability

Arbitration agreement

Indemnification

Contact Information

23.1 General Inquiries

Dreamline Dental Sleep Clinic

info@dreamlinedental.com

(660) 358-1277

www.dreamlinedental.com

Business Hours:

Mon-Fri: 8AM-6PM | Sat: By Appointment

23.2 Department-Specific Contacts

Patient Portal Support:

(660) 358-1277

Billing Questions:

(660) 358-1277

Privacy Officer:

Email: info@dreamlinedental.com

Phone: (660) 358-1277

Medical Records Requests: Contact Privacy Officer

23.3 Emergency Contact

Medical Emergencies:

Call 911 immediately

After-Hours Non-Emergency:

Leave message at (660) 358-1277

Callback within 24 business hours

23.4 Feedback and Complaints

General Feedback:

We welcome your feedback about our services via:

info@dreamlinedental.com
Patient portal messaging
In-person during appointments

Formal Complaints:

Privacy complaints:

See Privacy Policy Section 19

Service complaints:

Contact Practice Administrator at the general inquiry contact information listed above.

Acknowledgment and Acceptance

By using our services, accessing our website, enrolling in our patient portal, or receiving healthcare services from Dreamline Dental Sleep Clinic, you acknowledge that:

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You have read and understood these Terms of Service

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You have had the opportunity to ask questions

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You agree to be bound by these Terms

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You understand your rights and responsibilities

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You acknowledge these Terms may be updated periodically

For the most current version of these Terms, visit: www.dreamlinedental.com/terms

Last Updated

January 20, 2026

Effective Date

January 20, 2026