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Dental Release Of All Claims Form Template for England and Wales

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Key Requirements PROMPT example:

Dental Release Of All Claims Form

"I need a Dental Release Of All Claims Form for my private dental practice in London, covering a complex root canal treatment performed in January 2025, with specific provisions for potential future complications and insurance claims."

Document background
The Dental Release Of All Claims Form is a crucial document used in dental practices across England and Wales to protect both practitioners and practices from future liability claims. This document is typically employed following the completion of dental procedures, particularly in cases where there might be potential disputes or when settling existing disagreements. It includes comprehensive details about the treatment provided, any payments made, and specific terms of release. The form must comply with English and Welsh healthcare regulations, consumer protection laws, and General Dental Council guidelines. It serves as a legally binding agreement that, once signed, prevents the patient from making future claims related to the specified treatment.
Suggested Sections

1. Patient Information: Details of the patient including full name, address, date of birth, and contact information

2. Treatment Details: Specific dental procedures or treatments received, including dates and treating dentist information

3. Release Statement: Clear statement of claims being released and scope of release, including reference to relevant legislation

4. Consideration: Statement of any payment or consideration given for the release, if applicable

5. Acknowledgment: Patient acknowledgment of understanding the release terms and voluntary agreement

6. Execution: Signature blocks for patient and dental practice representative, including date fields

Optional Sections

1. Medicare/Insurance Information: Details of insurance coverage and claims, required when insurance or NHS claims are involved

2. Future Claims Waiver: Additional waiver of potential future claims, included when broader release is desired and legally permissible

3. Witness Statement: Section for witness details and signature, included when additional verification of signing is desired

4. Legal Representative Acknowledgment: Section for legal representative details and signature, required when patient has legal representation

5. Cooling-off Period Notice: Information about any applicable cooling-off period and right to cancel, included for consumer protection compliance

Suggested Schedules

1. Schedule A - Treatment Records: Detailed records of dental procedures performed, including dates and specific treatments

2. Schedule B - Payment Records: Documentation of all payments made or outstanding, including insurance payments if applicable

3. Schedule C - Medical History: Relevant medical and dental history affecting treatment and potential claims

4. Schedule D - Photographic Evidence: Any relevant dental photographs, x-rays, or other imaging related to the treatment

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈ˰æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

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Relevant Industries
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Industries

Consumer Rights Act 2015: Primary legislation governing consumer rights and unfair terms in consumer contracts, ensuring the release form is fair and transparent to dental patients

Limitation Act 1980: Establishes statutory time limits for bringing different types of legal claims, which must be considered in the release form's scope

Civil Liability Act 2018: Governs civil liability and damages in personal injury cases, relevant for dental malpractice claims

Data Protection Act 2018: UK's implementation of GDPR, ensuring proper handling of patient personal and medical data in the release form

Health and Social Care Act 2012: Framework legislation for healthcare service provision in England, including dental care standards and regulations

Dentists Act 1984: Specific legislation governing dental practice and professional standards in the UK

Medical Act 1983: Legislation relating to medical practitioners and healthcare professionals, including aspects of dental care

GDC Standards and Guidelines: Professional standards set by the General Dental Council that must be reflected in any dental release form

CQC Requirements: Care Quality Commission regulatory requirements for dental practices, including documentation standards

Unfair Contract Terms Act 1977: Controls unfair terms in contracts, ensuring the release form doesn't contain unreasonable or unenforceable provisions

Misrepresentation Act 1967: Governs false or misleading statements that might affect the validity of the release

NHS Constitution: Framework of patient rights within the NHS system, must be considered for NHS dental treatment releases

Mental Capacity Act 2005: Ensures proper consideration of patient capacity to understand and agree to the release form

Human Rights Act 1998: Protects fundamental rights that cannot be waived, even in a release form

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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