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Home > Patient Policies

Patient Policies

Please click below to review our patient policies that we have in place across Pediatric Dental Associates locations.

  • Patient Privacy Practices
  • Non-Discrimination Statement
  • Good Faith Estimate
  • Acknowledgment of Receipt of HIPAA Privacy Practices
  • HIPAA Authorization for Release of Health Information
  • Privacy Forms (Spanish)
  • Patient Privacy (continued)

If you need any of the forms in an additional language, please contact your local office.

Our Locations

Northeast Philadelphia

6595-C Roosevelt Blvd.

Philadelphia 19149

215-743-3700

Allegheny Ave

2301 East Allegheny Ave

Philadelphia 19134

215-282-8000

Ambler

7 East Skippack Pike

Ambler 19002

215-653-0420

Cherry Hill

805 Route 38

Cherry Hill 08002

856-281-7600

West Philadelphia

5629 Vine St.

West Philadelphia 19139

215-383-1376

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