Patient Guide

The Dr. Robert H. Hill II Dental Hygiene Clinic is the dental hygiene training facility of Hudson Valley Community College Dental Hygiene Department. What this means is that one or more of our students may be involved in your care. This is always done under the direct supervision of one or more licensed expert faculty members. Patients receive the direct benefits of this faculty-student collaboration, as well as affordable, high-quality dental care.  As such, treatment times may be greater than if performed in a private practice.

Initial Appointment
The first step in becoming a patient is to schedule an initial appointment. This initial appointment will consist of a completing a comprehensive review of your Medical and Dental History, a comprehensive series of examinations, and recommendation of any necessary radiographs (x-rays) and intraoral digital photographs to determine your treatment needs. This appointment is necessary to determine if your oral health needs are compatible with the educational needs of our students and to assign you to the most appropriate dental health team. Hudson Valley Community College Dental Hygiene reserves the right not to accept patients that are too advanced for our students abilities.

Preparing for Your Appointment
On your first appointment you will be asked to provide a detailed medical history and complete other necessary forms to become a patient of Hudson Valley Community College Dental Hygiene. Please arrive following the directives set forth by Hudson Valley Community College and bring your medical history information and a list of all medications/supplements that you are taking so that you can complete these forms and your appointment is not delayed. 

YOU HAVE THE RIGHT, CONSISTENT WITH LAW, TO:

1. Understand and use these rights
2. Receive treatment without discrimination as to infectious disease, age, gender, race, ethnicity, religion, disabling condition or sexual orientation.
3. Receive considerate and respectful care in a clean and safe environment.
4. Know that all Dental Hygiene Clinic policies and procedures follow state and federal bloodborne and infection control regulations.
5. Know in advance the cost of treatment.
6. Know that multiple appointments may be necessary for educational procedures, completion of treatment and referral.
7. Know the names, positions and functions of any dentist, dental hygiene instructors, staff and students in the dental hygiene clinic who are involved in your care.
8. Receive treatment which meets the ADHA Professional Standard of Care.
9. Know that the clinic maintains Quality Assurance Programs for Patient Records and Patient Care Appraisal to ensure continuity and completion of individual care.
10. Access, review and obtain your dental hygiene record.
11. Know your patient Care is not determined by students’ academic or clinical requirements.
12. Be informed of your individual needs, proposed patient care plan, expected treatment outcomes, treatment alternatives.
13. Receive continuity and completion of care through recare appointment and referrals.
14. Refuse examination, observation and treatment and be informed of the effects this may have on your health. All treatment and patient records are strictly confidential.
15. Receive complete information about any referral that is advised.
16. Receive all the information that you need to give informed consent for any proposed procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment.
17. Participate in all decisions about your treatment.
18. Complain without fear of reprisals about the care and services you are receiving.
19. Know the scope of dental hygiene services provided at this clinic.
20. Know the dental hygiene procedures which have been taught and evaluated to competency level prior to clinical application to patients.

Procedures include:

• Patient Assessment Treatment
• Medical/Dental Health Histories - Scaling/Periodontal Debridement
• Blood Pressure/Vital Signs - Application of Chemotherapeutic Agents
• Extra/Intra Oral Examination - Pain Management
• Periodontal/Dental Examination - Coronal Selective Polishing
• Study Models - Fluoride Therapy
• Intra-oral Photographs - Pit and Fissure Sealants
• Oral Cancer Screening - Dental Radiographs (x-rays)
• Preventive Oral Health Counseling
• Dietary Guidance

ADAPTED FROM THE "PATIENT'S BILL OF RIGHTS," PUBLISHED BY THE NEW YORK STATE DEPARTMENT OF HEALTH

Patient Code of Conduct

• Patient Policy Electronic Record
  The Dental Hygiene Clinic Students will ask you to sign-off in your Electronic Medical History Record that you understand and agree to these Policies. Thank You
• Teaching Policy
  We are pleased that you are considering Hudson Valley Community College for your oral hygiene health care. It is our objective to care for your dental hygiene needs in the most professional and courteous manner possible. We teach and practice comprehensive dental hygiene care and provide up-to-date preventive and therapeutic dental hygiene services. As a teaching institution, you may spend several visits before a definitive step-by-step treatment sequence is determined. You may require types of dental treatment that are beyond the scope of the program. In those cases, we will offer a referral to another facility. We hope you understand our concern for your care.
• Missed Appointment Policy
  Please try to be prompt when scheduled and give us 48 hours notice (Dental Hygiene Clinic Phone: (518) 629-7400) if you must cancel. If two appointments are missed, without 24 hours notice, we will have the right to discontinue treating you at our Dental Hygiene Clinic.
• Photography/Videography Policy
  On rare occasions HVCC may photo/videos tape various events on campus. I authorize HVCC-DHY to take photographs or videotapes of myself, and if applicable, my child during the course of my/our treatment for the purpose of enhancing my/our care, education.
• Sexual Harassment Policy
  Hudson Valley Community College has zero tolerance for sexual harassment. Sexual Harassment is unacceptable and in conflict with the policies and mission of the college. The college will act promptly and equitably, within the framework of due process, to investigate alleged sexual harassment and to effect a remedy when such allegations are determined to be valid.
• Infectious Disease Management Policy
  All students and clinical personnel are required to follow standard precautions. The Dental Hygiene Department’s policies and procedures comply with guidelines issued by the U.S. Public Health Service, Centers of Disease Control and Prevention (CDC), Environmental Protection Agency (EPA), Food and Drug Administration (FDA), the American Dental Association (ADA), Occupational Safety and Health Administration (OSHA) and the Organization for Safety and Asepsis Procedures (OSAP).
• Radiation Management Policy
  Dental radiographs may be recommended as part of a patient’s comprehensive care. The American Dental Association (ADA), in collaboration with the U.S. Food and Drug Administration (FDA), have developed guidelines for patient selection and limiting radiation exposure. Hudson Valley Community College Dental Hygiene Clinic adheres to these guidelines in the prescription and exposure of dental radiographs. The ADA/FDA guidelines will be provided to patients upon request.

Consents and Policies
Below, are copies of the consents and policies that you will be asked to sign electronically. Please review the information carefully and keep this information for your records.

• Patient Guide
  I acknowledge that I was provided with an electronic copy of the Guide to Patient’s Services.
  I have read, understand, and agree to abide by the aforementioned appointment policy. I acknowledge that I was provided with an electronic copy of the Hudson Valley Community College Department of Dental Hygiene Notice of Privacy Practices. I acknowledge that I reviewed and understand the consent to dental treatment You will be asked to provide an electronic signature in acknowledgment of the above. 
• Patients who are Minors
  A parent or legal guardian must accompany patients who are minors at every visit. This accompanying adult is responsible for providing complete and accurate information regarding the patient’s medical and dental health as well as agreeing to consent for proposed treatment.
• Appointment Policy
  We take great pride in the quality of care that we deliver. In an effort to maintain this high-level of care, we have instituted appointment guidelines regarding cancellation /no-show/lateness. Compliance with this policy will allow patients to receive treatment in a timely and efficient manner, promoting optimal care and oral health. 
  1. Once appointments are scheduled, patients are expected to attend each and every session at the appointed time.
  2. If you are going to be more than 15 minutes late for your scheduled appointment, please call to let us know so that we may notify your student hygienist.
  3. All cancellations must be communicated to the department 48 hours in advance.
  4. If you cancel or fail to show for two consecutive visits, you may be discharged from being provided care at our facility.
  5. The College reserves the right not to reschedule patients who have been discharged for failing to show for prior scheduled appointments.
     
     Hudson Valley Community College Department of Dental Hygiene reserves the right to discontinue dental treatment at its sole discretion.  If you have a complaint that cannot be resolved at the student or faculty level, please contact the Department Chair at (518) 629-7442.
     
     We appreciate your understanding and cooperation with this policy.

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect February 16, 2026 and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law, and to make new Notice provisions effective for all protected health information that we maintain. When we make a significant change in our privacy practices, we will change this Notice and post the new Notice clearly and prominently at our practice location, and we will provide copies of the new Notice upon request.

You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
We may use and disclose your health information for different purposes, including treatment, payment, and health care operations. For each of these categories, we have provided a description and an example. Some information, such as HIV-related information, genetic information, alcohol and/or substance use disorder treatment records, and mental health records may be entitled to special confidentiality protections under applicable state or federal law. We will abide by these special protections as they pertain to applicable cases involving these types of records.

Treatment. We may use and disclose your health information for your treatment. For example, we may disclose your health information to a specialist providing treatment to you.

Payment. We may use and disclose your health information to obtain reimbursement for the treatment and services you receive from us or another entity involved with your care. Payment activities include billing, collections, claims management, and determinations of eligibility and coverage to obtain payment from you, an insurance company, or another third party. For example, we may send claims to your dental health plan containing certain health information.

Healthcare Operations. We may use and disclose your health information in connection with our healthcare operations. For example, healthcare operations include quality assessment and improvement activities, conducting training programs, and licensing activities.

Individuals Involved in Your Care or Payment for Your Care. We may disclose your health information to your family or friends or any other individual identified by you when they participate in your care or in the payment for your care. Additionally, we may disclose information about you to a patient representative. If a person has the authority by law to make health care decisions for you, we will treat that patient representative the same way we would treat you with respect to your health information.

Disaster Relief. We may use or disclose your health information to assist in disaster relief efforts.

Required by Law. We may use or disclose your health information when we are required to do so by law.

Public Health Activities. We may disclose your health information for public health activities, including disclosures to: • Prevent or control disease, injury or disability; • Report child abuse or neglect; • Report reactions to medications or problems with products or devices; • Notify a person of a recall, repair, or replacement of products or devices; • Notify a person who may have been exposed to a disease or condition; or • Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.

National Security. We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institution or law enforcement official having lawful custody the protected health information of an inmate or patient.

Secretary of HHS. We will disclose your health information to the Secretary of the U.S. Department of Health and Human Services when required to investigate or determine compliance with HIPAA.

Worker’s Compensation. We may disclose your PHI to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.

Law Enforcement. We may disclose your PHI for law enforcement purposes as permitted by HIPAA, as required by law, or in response to a subpoena or court order.

Health Oversight Activities. We may disclose your PHI to an oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and credentialing, as necessary for licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Judicial and Administrative Proceedings. If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process instituted by someone else involved in the dispute, but only if efforts have been made, either by the requesting party or us, to tell you about the request or to obtain an order protecting the information requested.

Research. We may disclose your PHI to researchers when their research has been approved by an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information.

Coroners, Medical Examiners, and Funeral Directors. We may release your PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also disclose PHI to funeral directors consistent with applicable law to enable them to perform their duties.

Fundraising. We may contact you to provide you with information about our sponsored activities, including fundraising programs, as permitted by applicable law. If you do not wish to receive such information from us, you may opt out of receiving the communications.

SUD Treatment Information. How We Protect Information About Substance Use Disorder Treatment. At our practice, your privacy is our priority—especially when it comes to sensitive health information such as substance use disorder (SUD) treatment records. If Your SUD Information Comes From a Specialized Treatment Program Some SUD treatment programs are protected under a federal rule called 42 CFR Part 2, which gives extra privacy safeguards. If you give that program a general consent, we may use or share your treatment information only for your care, for billing, or for our normal health care operations. If you give specific consent directly to us or another organization, we will use or share your information only in the exact ways you authorize. Your Information Is Strongly Protected We will never use or disclose your SUD treatment information—or any testimony about it—in any legal, criminal, administrative, or government proceeding unless: You give written permission, or A court issues an order and you are notified before any information is released. We take these protections seriously and follow all federal rules that keep your SUD information private and secure.

OTHER USES AND DISCLOSURES OF PHI
Your authorization is required, with a few exceptions, for disclosure of psychotherapy notes, use or disclosure of PHI for marketing, and for the sale of PHI. We will also obtain your written authorization before using or disclosing your PHI for purposes other than those provided for in this Notice (or as otherwise permitted or required by law). You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing your PHI, except to the extent that we have already acted in reliance on the authorization.

YOUR HEALTH INFORMATION RIGHTS
Access. You have the right to look at or get copies of your health information, with limited exceptions. You must make the request in writing. You may obtain a form to request access by using the contact information listed at the end of this Notice. You may also request access by sending us a letter to the address at the end of this Notice. If you request information that we maintain on paper, we may provide photocopies. If you request information that we maintain electronically, you have the right to an electronic copy. We will use the form and format you request if readily producible. We will charge you a reasonable cost-based fee for the cost of supplies and labor of copying, and for postage if you want copies mailed to you. Contact us using the information listed at the end of this Notice for an explanation of our fee structure. If you are denied a request for access, you have the right to have the denial reviewed in accordance with the requirements of applicable law.

Disclosure Accounting. With the exception of certain disclosures, you have the right to receive an accounting of disclosures of your health information in accordance with applicable laws and regulations. To request an accounting of disclosures of your health information, you must submit your request in writing to the Privacy Official. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to the additional requests.

Right to Request a Restriction. You have the right to request additional restrictions on our use or disclosure of your PHI by submitting a written request to the Privacy Official. Your written request must include (1) what information you want to limit, (2) whether you want to limit our use, disclosure or both, and (3) to whom you want the limits to apply. We are not required to agree to your request except in the case where the disclosure is to a health plan for purposes of carrying out payment or health care operations, and the information pertains solely to a health care item or service for which you, or a person on your behalf (other than the health plan), has paid our practice in full.

Alternative Communication. You have the right to request that we communicate with you about your health information by alternative means or at alternative locations. You must make your request in writing. Your request must specify the alternative means or location, and provide satisfactory explanation of how payments will be handled under the alternative means or location you request. We will accommodate all reasonable requests. However, if we are unable to contact you using the ways or locations you have requested, we may contact you using the information we have.

Amendment. You have the right to request that we amend your health information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances. If we agree to your request, we will amend your record(s) and notify you of such. If we deny your request for an amendment, we will provide you with a written explanation of why we denied it and explain your rights.

Right to Notification of a Breach. You will receive notifications of breaches of your unsecured protected health information as required by law.

Electronic Notice. You may receive a paper copy of this Notice upon request, even if you have agreed to receive this Notice electronically on our Web site or by electronic mail (e-mail).

QUESTIONS AND COMPLAINTS

If you want more information about our privacy practices or have questions or concerns, please contact us.

If you are concerned that we may have violated your privacy rights, or if you disagree with a decision we made about access to your health information or in response to a request you made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information listed at the end of this Notice. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.

We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.

PRIVACY OFFICIAL NAME AND CONTACT INFORMATION:

Contact Officer: Tammy J. Conway Dept. Chair
Telephone: (518) 629-7442
Fax: (518) 629-8115
Email:  privacy@hvcc.edu
Address: 80 Vandenburgh Avenue, Troy, NY 12180

This material is educational only, does not constitute legal advice, and covers only federal, not state, law. Changes in applicable laws or regulations may require revision. Dentists should contact their personal attorneys for legal advice pertaining to HIPAA compliance, the HITECH Act, and the U.S. Department of Health and Human Services rules and regulations.

Reproduction of this material by dentists and their staff is permitted. Any other use, duplication or distribution by any other party requires the prior written approval of the American Dental Association. This material is educational only, does not constitute legal advice, and covers only federal, not state, law. Changes in applicable laws or regulations may require revision. Dentists should contact their personal attorneys for legal advice pertaining to HIPAA compliance, the HITECH Act, and the U.S. Department of Health and Human Services rules and regulations.

© 2010–2025 American Dental Association. All Rights Reserved.

Patients have the right to express concerns or complaints without fear of reprisal and with the assurance that the presentation of a complaint will not compromise the quality of their care or future access to care.

Patients who have concerns about any aspect of the dental care or treatment they have received at the Dr. Robert H. Hill II Dental Hygiene Clinic should discuss their concerns with the supervisor of the program where dental care was rendered. Patients may also register that concern either in person, by telephone, or in writing to the Department of Dental Hygiene.

Department Chairperson
Tammy J. Conway RDH, MS
Fitzgibbons Health Technologies Center, Room 157
80 Vandenburgh Avenue
Troy, NY 12180
(518) 629-7442