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Sunflower Dental Group Cancellation Policy

At Sunflower Dental Group, we value your time and strive to provide the best care possible. To ensure we can meet the needs of all our patients, we have established the following cancellation policies:

Private and Privately Insured Patients:

1. Cancellation Fee: A $75 fee will be charged for appointments canceled without providing at least 24 hours' notice, except under unique circumstances, as determined at the discretion of our office.

2. Deposit for Long Appointments: For appointments scheduled to last longer than one hour, a $150 deposit is required. This deposit will be applied to your bill at the time of service. However, if the appointment is canceled without providing at least 24 hours' notice, the deposit will be forfeited. If the patient does not reschedule the appointment, the deposit will not be refunded.

3. Appointment Limitations After Cancellations: If a patient has two unreasonable cancellations within a 12-month period, they will lose the ability to schedule future appointments. Instead, the patient will need to call daily for availability or may request to transfer their care to another dental provider.

Medicaid Patients:

Medicaid patients who have two unreasonable cancellations or no-shows within a 12-month period will also lose the ability to schedule appointments. They will need to call daily for availability or transfer their care to another dentist. We understand that unforeseen circumstances may arise, and we are happy to accommodate reasonable exceptions at our discretion. If you have any questions regarding this policy, please contact our office.

Thank you for your understanding and cooperation.

Notice of Privacy Practices

Effective October 1, 2026

Sunflower Dental Group

Discrimination is Against the Law

Sunflower Dental Group complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR § 92.101(a)(2)). Sunflower Dental Group does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.

Sunflower Dental Group:

• Provides people with disabilities reasonable modifications and free appropriate auxiliary aids and services to communicate effectively with us, such as:
  • Qualified sign language interpreters
  • Written information in other formats (large print, audio, accessible electronic formats, other formats)
• Provides free language assistance services to people whose primary language is not English, which may include:
  • Qualified interpreters
  • Information written in other languages

If you need reasonable modifications, appropriate auxiliary aids and services, or language assistance services, contact the Office Manager at support@sunflowerdentalgroup.com, 201-488-1164 for Teaneck, or 201-497-6532 for Westwood.

If you believe that Sunflower Dental Group has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with the Office Manager, Sunflower Dental Group, at 265 Cedar Lane, 3rd Floor, Teaneck, NJ 07666 or 316 Kinderkamack Road, Unit C, Westwood, NJ 07675; by telephone at 201-488-1164 or 201-497-6532; or by email at support@sunflowerdentalgroup.com.

You can file a grievance in person or by mail or email. If you need help filing a grievance, the Office Manager is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal ↗, or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at hhs.gov/ocr/office/file ↗.

Source: HHS model Notice of Nondiscrimination (PDF) ↗

Free Language Assistance and Accessible Formats

ATTENTION: If you speak a language other than English, free language assistance services are available to you. Appropriate auxiliary aids and services to provide information in accessible formats are also available free of charge. Call 1-201-488-1164 or speak to your provider.

For the Westwood office, call 1-201-497-6532. If your language is not shown below, tell the front desk. Sunflower Dental Group will arrange appropriate assistance free of charge.

These notices use the current HHS § 92.11 model translations. Chinese is provided in both Simplified and Traditional scripts.