Patient-Dentist Arbitration Agreement

It is understood that any dispute as to medical malpractice, that is as to whether any medical services rendered under this contract were unnecessary or unauthorized or were improperly, negligently or incompetently rendered, will be determined by submission to arbitration as provided by California law, and not by a lawsuit or resort to court process except as California law provides for judicial review of arbitration proceedings. Both parties to this contract, by entering into it, are giving up their constitutional right to have any such dispute decided in a court of law before a jury, and instead are accepting the use of arbitration.

Article 1 and the notice above the signature line use the words California law requires (Code of Civil Procedure § 1295). In this agreement, “medical malpractice” includes dental malpractice, and “medical services” includes every dental service the practice provides, including surgery, sedation and anesthesia, imaging, and prosthetic and laboratory work.

“The practice” means the dentists and the professional corporation named at the end of this form under “Responsible clinicians”, together with the corporation’s other dentists, employees and agents, at either of its offices.

This agreement binds you and everyone whose claim could arise from your dental care with the practice, including your spouse or registered domestic partner, your heirs, and your children, whether born or unborn at the time of the event that gives rise to the claim. It covers claims for wrongful death and for loss of consortium. When a parent or legal guardian signs for a minor, the agreement binds the minor and cannot later be disaffirmed (Code of Civil Procedure § 1295(d)).

The agreement covers any dispute described in Article 1 about care the practice gives you on or after the day you sign, at either office, now or in the future. Any other dispute between you and the practice about the dental services the practice provides to you, or about payment for them, is also decided by arbitration, whichever side raises it.

It covers care the practice gave you before the day you sign only if you answer “Yes” to the question on this form about earlier care. It covers nothing beyond the practice’s dental services and their billing.

Either you or the practice may instead take a claim to small claims court when the claim is within that court’s limits.

Either side starts an arbitration by sending the other a written demand that describes the dispute. One neutral arbitrator hears it: a retired California judge, or an attorney licensed in California for at least ten years, who makes the disclosures California law requires (Code of Civil Procedure § 1281.9). You and the practice choose the arbitrator together within 30 days of the demand; if you do not, either side may ask the Superior Court to appoint one (Code of Civil Procedure § 1281.6).

The arbitration is held in the county of the office where the care was given, unless both sides agree otherwise. The California Arbitration Act applies (Code of Civil Procedure § 1280 and following), including the discovery rights of Code of Civil Procedure §§ 1283.05 and 1283.1.

The arbitrator decides the dispute under California law, including, as amended from time to time, Civil Code §§ 3333.1 and 3333.2, Code of Civil Procedure §§ 340.5 and 667.7, and Business and Professions Code § 6146 — the same laws a court would apply. The award is final and binding, subject only to review by a court as California law provides.

The practice pays the neutral arbitrator’s fees and any administrative fees of the arbitration, and pays them on time (Code of Civil Procedure §§ 1281.97–1281.99). You and the practice each pay your own attorneys and expert witnesses.

This agreement never requires you to pay the practice’s attorney fees or costs, or the arbitrator’s fees, whatever the outcome (Code of Civil Procedure § 1284.3).

This agreement takes effect when you sign it. You may rescind it by written notice to the practice within 30 days after you sign: hand or mail a signed note saying you rescind the arbitration agreement to either office, or email it to the address at the top of this form. If the patient is a minor or is incapacitated, a parent, guardian or conservator may give the notice (Code of Civil Procedure § 1295(c)).

After those 30 days you may still end the agreement for care you receive after the practice receives your written notice; care received before then stays covered. Rescinding or ending the agreement does not change your care in any way.

You do not have to sign this agreement to receive care from the practice, and the practice will not end your care because you decline it, rescind it, or end it later.

Take the time you need. You may take this agreement home, ask us any question about it, and talk to a lawyer of your own before you sign. Our staff can go through it with you in your language. Do not sign it while sedated, in pain, or rushed.

Before an arbitration starts, either side may ask the other to try to resolve the problem informally or through mediation. Doing so is voluntary and does not change any deadline for bringing a claim.

This agreement decides only how a dispute is resolved. It does not change the care the practice owes you, limit what you may claim, or replace any consent to treatment.

If a court or an arbitrator finds any part of this agreement unenforceable, that part is removed and the rest stays in effect.