Request for Mediation

CDA has developed an informal mediation program in which a volunteer dentist mediator facilitates communication between a patient and member dentist to assist them in identifying a mutually acceptable agreement. The mediation process is voluntary and does not involve an evaluation of the treatment or result in a ruling.

If you are interested in submitting a mediation request, please complete the form below. The more clearly you can describe your concerns the more effective the system can be. You will receive additional communication once your request has been received and reviewed.

Mediation may include telephone calls or virtual meetings and documents will be sent via encrypted email/confidential electronic systems. A valid telephone number and email are required for participation.