The volunteer dentist will contact the participating laboratory with a case. Each case will be given a case authorization number (for example 00011) assigned by Give Back a Smile (GBAS). The number will be used at all times for communication purposes, in order to keep the confidentiality of the domestic violence survivor/patient intact.
To ensure that donated lab work is provided only for individuals who have passed the program screening criteria of the GBAS program, GBAS will send a “GBAS Donated Lab Work” form to the volunteer dentist. When the case is sent to the lab for processing, this form must be included. The lab is responsible for filling in the remainder of the form and returning it to GBAS.
Due to survivor/patient confidentiality and safety, facial photographs of the patient may not be used for marketing and/or advertising purposes unless a specific agreement is made in writing by the patient. The AACD should be notified of any such specific arrangements.
Note: Facial photographs are normally taken during the course of active cosmetic dental treatment. However, for the protection and safety of the survivor/patient, it is imperative that both the lab and the dentist involved not lose possession of these photographs nor share them with anyone not involved with the case.
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American Academy of Cosmetic Dentistry
200 River Place STE 150
Monona, WI 53716
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