| Term 
 
        | The hours for registering for the morning clinic are? The afternoon clinic? |  | Definition 
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        | Term 
 
        | Do you need an appt for limited care? Limited Care patients will be charged a fee of $___ and it includes? |  | Definition 
 
        | No $40.00 includes a problem-focused evaluation and a radiograph |  | 
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        | Term 
 
        | Do you need an appt for treatment plans? Treatment plans will be charged a fee of $___ and it includes? |  | Definition 
 
        | Yes $80 includes a comprehensive oral evaluation and full mouth radiographs |  | 
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        | Term 
 
        | Refunds are processed to the patient through _____ and can take ___ weeks |  | Definition 
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        | Term 
 
        | The school of Dentistry is an in-network provider for? Also accept Medicaid for qualified patients younger than __ |  | Definition 
 
        | Blue Cross Clue Shield of Alabama and MetLife 21 |  | 
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        | Term 
 
        | What is the effective date for the Notice of Health Infomation Practices? |  | Definition 
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        | Term 
 
        | Who do you contact if you do not want UAB SOD to contact you for fundraising effort? |  | Definition 
 
        | UAB School of Dentistry Privacy Coordinator in writing |  | 
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        | Term 
 
        | If you believe your privacy rights have been violated, you may file a complaint with_______ or _____ |  | Definition 
 
        | UAB School of Dentistry or with the Secretary of the Department of Health and Human Services |  | 
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        | Term 
 
        | To file a complaint with the UAB School of Dentistry, contact the _________ |  | Definition 
 
        | Entity Privacy Coordinator |  | 
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