Release of Liability - In most cases, this form is used when a previous patient is unhappy with the dental care received at the Atlanta Dental Group PC. In exchange for a monetary payment, usually a refund of money for incomplete dental care, the patient agrees not to sue, or complain in any way about, any of the doctors or staff at the Atlanta Dental Group PC.
Assignment of Claim - This form is used when a patient has been allowed ( against normal policy ) to receive dental treatment and payment will be delayed until the patient's legal settlement is completed.
Model Release - This form is used when photographs of a model are used by the Atlanta Dental Group PC in advertising or marketing materials. It gives legal permission for the photographs to be used in any way that the Atlanta Dental Group PC wishes.
There are a number of official forms that must be completely and correctly filled out BEFORE your employment with the Atlanta Dental Group PC begins. Each form is listed below and can be downloaded using the Adobe Portable Document Format ( PDF ). Please download and print out each and every one of the forms below and carefully complete each and every one. Failure to complete and sign all of these forms may prevent you from joining our staff or from receiving your paycheck on time.
General Staff Information Sheet - This form is used to insure that each staff member has met the Atlanta Dental Group PC minimum educational requirements
Employee Payroll Information Form - This form is used to create your payroll file and prepare your paycheck.
W 4 - The W4 form is used to calculate the amount of Federal Tax which must legally be removed from your pay.
G 4 - The G4 form is used to calculate the amount of Georgia Tax which must legally be removed from your pay.
I 9 - The United States government requires a completed I9 form to verify that all staff are eligible for US employment.
Direct Deposit - All staff can direct deposit their pay into their personal checking account.
Confidentiality Agreement - The staff at the Atlanta Dental Group PC are intimately involved with sensitive patient and company information and must legally agree to keep patient and company information confidental and private.