Broken Appointment--Less than 24 hour notice.

Many offices have chosen to institute a fee for broken appointments, we have decided that this is not appropriate for our office. We understand that everyone can have an "off" day and miss one appointment. For those people who miss more than one appointment, we remind them of the need to give 24 hour advance notice. For those patients who are unable to do this, and who then miss repeated appointments, we are unable to pre-schedule appointment time. We are forced to place the patient on our short-call/on-call list for any openings we have that come available; at which time we call the patient to come in if convenient. For those patients who are unable to keep appointments, even when scheduled on a short-term basis, we feel it is best that they find a dentist with hours more convenient for them.



Before/After Hours appointments.

Appointments scheduled before or after regular office hours may be charged a fee in addition to the scheduled treatment fees.



Emergency Phone Consultation.

Phone consultations, where a prescription is given or treatment options are discussed, may be considered as equal to a limited exam/office visit and a fee billed accordingly.

**If an operative appointment is cancelled or rescheduled with less than 24 hour notice, then our Before/After Hours fee may be charged for each subsequent emergency phone consultation (with regards to rescheduled treatment) in addition to phone consult fee.


Written Treatment Authorization not required for diagnostic/routine care.

The act of a patient scheduling a routine operative or maintenance appointment, will be considered as authorization for Dr. Scott Soderstrom and Staff to take x-rays, study models, photographs, or any other diagnostic aids deemed appropriate by doctor to make a thorough diagnosis of the patient's dental needs.

It is our policy that written authorization is not required for Dr. Soderstrom and Staff to perform all recommended routine/diagnostic treatment verbally agreed upon by the patient, or responsible party, and to use the appropriate medication and therapy indicated for such treatment in connection with the patient care.

Consent forms for special treatment will be kept on file in the patient chart. (i.e.: Oral Surgery, Implants...)


Medical History/Medication.

Health history forms will be reviewed at each appointment, with new forms updated periodically. Patient is aware if they ever have any change in health, they are required to inform the staff and doctor at the next appointment without fail.

Clyndamycin and Amoxicillin are kept on hand in the office for patient's convenience for pre-medication purposes, and may be dispensed for an add fee per visit. In most cases, pre-medication must be taken 1 hour prior to treatment so an office dispersal is not always feasible. It is the patients responsibility to take pre-medication in a timely manner and appointments will be rescheduled if pre-medication is not taken.

Nitrous Oxide is available upon request for an added per visit.


X-rays & Diagnostic Exams

Standard Care will be evaluated and determined on a per patient basis by Registered Dental Hygienist and /or Dentist. "Standard Diagnostic Continuing Care Regimen" is as follows:

  • Posterior Bitewing x-rays will be taken approximated 1 time per calendar year

  • Anterior and/or Full mouth series/panolipse x-rays taken at first visit then every 3-5 years

  • 2 Anterior "Cookie or Cracker" x-rays (or panolipse) may be taken between the ages of 4 and 8 to determine existence/eruption of permanent teeth

  • Probe readings will be recorded every 12-18 months

  • Fluoride will be applied 2 times per year for all children under age 19, unless advised otherwise by parent.


Refusal of x-rays to be kept on file.Responsibility for refusal of care is to be documented and kept on file in the patient chart. Patient may choose to refuse diagnostic radiographs recommended by the doctor and staff of Scott L Soderstrom, DDS, PC. Patient understand that diagnostic x-rays enable the dentist to spot hidden trouble areas; such as decay between the teeth and under existing restorations, infection, cysts, tumors and bone breakdown or bone disease, all of which are not visible to the eye. Patient understands the fact that refusal may lead to future dental problems and that the examination received will not be as thorough as possible due to the lack of this diagnostic tool. Patient accepts full responsibility for any such problems, which may arise from refusal of recommended treatment. Patient understands that treatment may not be possible without x-rays and that it is at Dr.Soderstrom's discretion to choose to terminate the patient's relationship with the office and end continuation of care if x-rays are refused.


Records Disclosure Upon Request.

We keep a record of the health care services we provide you. You may ask us to see and copy that record. You may also ask us to correct that record. We will not disclose your record to others unless you give us written direction to do so or unless the law authorizes or compels us to do so. You may schedule to see your record or get more information about it by written request at the front desk. As defined in the Uniform Health Care Information Act, we do have the right to deny access to your records, or to a portion of your record in special circumstances.

Records may be duplicated for release to another caregiver. In the case of referring care to specialist, written authorization is not required so long as we remain your primary caregiver. A fee may be charged for records duplication as provided for in RCW 70.02.010(12). Fees will not exceed the amount set by law. If a patient's account is deemed to be current at the time of transfer/records request, then our regular duplication fee will be waived.

A valid authorization must identify the nature of the information to be disclosed, must be dated and signed by the patient or guardian in the case of a minor, and must identify the name, address and institutional affiliation of the person to whom the information is to be disclosed. By law, authorizations are valid for 90 days only.

When records are to be forwarded to another dentist as a change of primary caregiver, we will forward only duplicates of current x-rays (1 year for bitewings, 3-5 years for fmx/pano) unless directed to provide additional information. (copies of periodontal charting if available-will be sent upon request).



Patient Accounts

PAYMENT OF ESTIMATED PATIENT PORTION IS DUE AT TIME OF SERVICEIn the event that payment arrangements are made, a finance charge (12%APR) will apply on any balance still pending 30 days from the date of service. This finance charge will be applied on or about the fifteenth of each month. If payment is not made by agreed upon date, a late charge may be added to the account.All written fee plans are estimates only. Estimate amounts will be honored for 3 months after date of diagnosis and fees are subject to change at any time after that date.For your convenience: We would be happy to bill insurance for services rendered but, remember, the patient is responsible for any amount not covered by insurance for any reason. Please be sure to confirm the plan benefits agree with those estimated and that remaining benefits are sufficient to complete treatment.


Copyright © 2017 Scott Soderstrom, DDS