Peer Review Request

The ODA provides Peer Review free services as part of its mission of supporting the public for quality dentistry in Oregon.

If your complaint involves a non-ODA member dentist you may be referred to another agency.

The ODA does not have jurisdiction over conflicts regarding: Fees, insurance claims, scheduling appointments, out of state dentists, and personality disputes involving the provider or staff. (Treatment related matters more than 3 years from last date of service will not be accepted due to statute of limitations).

Name of patient

Name of guardian if patient is a minor

Last date of treatment in question

Patient's daytime phone

Patient's address

Patient or guardian's email address

Name of treating dentist(s) excluding clinic name (required)

Dentist(s) address and phone

Has any part of this matter been review by; the Oregon Board of Dentistry, a small claims court, attorney, or arbitration? If yes, please specify.

Briefly explain the nature of your complaint include; names and dates of all dentists who have treated you for the same issue.

Peer Review Request

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