SCHEDULE 4PATIENT INFORMATION LEAFLET

Regulation 24 and paragraph 34 of Schedule 3

A patient leaflet shall include—

1

The name of the contractor.

2

In the case of a contract with a partnership—

a

whether or not it is a limited partnership; and

b

the names of all the partners and, in the case of a limited partnership, their status as a general or limited partner.

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In the case of a contract with a limited liability partnership—

a

whether or not it is a limited liability partnership;

b

the names of the members of the limited liability partnership; and

c

the registered premises address of the limited liability partnership.

3

In the case of a contract with a dental corporation—

a

the names of the directors, chief executive and secretary of the corporation, in so far as those positions exist in relation to the dental corporation; and

b

the address of the corporation's registered office.

4

The full name of each person performing services under the contract.

5

In the case of each person performing dental services under the contract, his professional qualifications.

6

Whether the contractor undertakes the teaching or training of persons who provide dental services or who intend to do so.

7

The address of each of the practice premises.

8

The contractor's telephone and fax numbers and the address of its website (if any).

9

Whether the practice premises have suitable access for disabled patients and, if not, the alternative arrangements for providing services to such patients.

10

How to request services as a patient.

11

The rights of a patient to express a preference of practitioner in accordance with paragraph 2 of Schedule 3 and the means of expressing such a preference.

12

The services available under the contract.

13

The normal surgery days and hours of the practice.

14

The arrangements for dental services for the hours and days that fall outside normal surgery hours (whether or not provided by the contractor) and how the patient may contact such services.

15

If the services in paragraph 14 are not provided by the contractor, the fact that F3the Board referred to in paragraph 21 is responsible for commissioning the services.

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17

How patients may make a complaint or comment on the provision of service.

18

The rights and responsibilities of the patient, including keeping appointments.

19

The action that may be taken where a patient is violent or abusive to the contractor, its staff, persons present on the practice premises or in the place where treatment is provided under the contract or other persons specified in paragraph 3 of Schedule 3.

20

Details of who has access to patient information (including information from which the identity of the individual can be ascertained) and the patient's rights in relation to disclosure of such information.

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The full name, postal, email and website address, and telephone number of the Board.