OPT-In is not a covered entity or a business associate of its member dental providers or affiliates, as such terms are defined by the Health Insurance Portability and Accessibility Act of 1996, as amended, or any regulations promulgated thereunder. Although its members and affiliates may compensate OPT-In to be listed on this site, this rating service is a benefit offered specifically to assist patients in selecting dental providers. You are directed to the Terms of Use governing this site at http://www.optindentaladvantage.com/terms-of-use/ for further information. Any information you voluntarily submit on this form may be disclosed to the dentist being rated or to any other third party. In the event that you submit a negative review and OPT-In believes it may need to obtain your protected health, or otherwise confidential, information from your dental provider in order to investigate the matter, you will be contacted by one of OPT-In’s representatives and asked to sign a HIPAA authorization, which will allow your dentist to disclose your protected health information to OPT-In. By using this rating service, you certify that you have received this disclosure, that you hereby consent to being contacted by OPT-In’s representative and that you understand that OPT-In retains sole authority regarding whether to post a rating of its members and may not post a rating in the event it does not, in its sole discretion, believe such a rating is truthful or otherwise substantiated.