We want to encourage you, as a patient at Black Hills Pediatric Dentistry, to speak openly with your health care team, take part in your treatment choices, and promote your own safety by being well informed and involved in your care. Because we want you to think of yourself as a partner in your care, we want you to know your rights as well as your responsibilities while here. We invite you and your family to join us as active members of our care team.

Your Rights

  • You have the right to receive considerate, respectful care regardless of your age, gender, race, national origin, religion, sexual orientation, gender identity, or disabilities.
  • You have the right to be told the names of your doctors, dental assistants, and all health care team members directing and/or providing your care.
  • You have the right to be told by your doctor about your diagnosis and possible prognosis, the benefits and risks of treatment, and the expected outcome of treatment, including unexpected outcomes.
  • You can expect full consideration of your privacy and confidentiality in care discussions, exams, and treatments.
  • You have the right to access protective and advocacy services in cases of abuse or neglect.
  • You and family have the right to participate in decisions about your care, treatment and services provided, including the right to refuse treatment to the extent permitted by law. If you leave Black Hills Pediatric Dentistry (BHPD) against the advice of your doctor, BHPD and doctors will not be responsible for any medical consequences that may occur.
  • You have the right to communication that you can understand.
  • You have the right to receive information regarding Advanced Directives and ask questions if you need assistance.
  • You have the right to be involved in your discharge plan. Before your discharge, you can expect to receive information about follow-up care that you may need.
  • You have the right to receive information about your charges.
  • You can expect that all communication and records about your care are confidential, unless disclosure is permitted by law. You have the right to see or receive a copy of your medical records. You have the right to request a list of people to whom your personal health information was disclosed.
  • You have the right to voice your concerns about the care you receive. If you have a problem or complaint, you may talk with your doctor, manager or our clinic’s CEO e-mail us at [email protected]. If your concern is not resolved to your liking, you may also contact: The South Dakota Department of Health at (605) 773-3376- 600 E. Capital Avenue, Pierre, SD 57501-2301

Your Responsibilities

  • You are expected to provide complete and accurate information, including your full name, address, telephone phone number, date of birth, Social Security number, insurance carrier and employer, when it is required.
  • You are expected to provide complete and accurate information about your health and medical history, including present condition, past illnesses, hospital stays, medicines, vitamins, herbal products, and any other matters that pertain to your health, including perceived safety risks.
  • You are expected to ask questions when you do not understand information or instructions. If you believe you can’t follow through with your treatment plan, you are responsible for telling your doctor. You are responsible for the outcome if you do not complete the care, treatment and follow-up as agreed upon.
  • You are expected to treat all staff, other patients and visitors with courtesy and respect; and be mindful of noise levels, privacy and number of visitors.
  • You have the responsibility to keep appointments, be on time, and call to reschedule prior to appointment date if you cannot keep your appointment.

Black Hills Pediatric Dentistry strives to provide excellent patient care and services. If you should have a concern or complaint, please tell us so we can work to satisfy your needs. Ask to speak with the CEO of our facility, Jim Dickerson 605-341-3068.


If the patient has further concerns about the care being provided in this dental clinic, they may express concern to the Practice Administrator or any staff member within the dentistry according to the pediatric dentistry policy. They may also file a complaint with the South Dakota Department of Health at (605) 773-3376- 600 E. Capital Avenue, Pierre, SD 57501-230.