It`s that time of year! 2015 Shred Event

It’s that time of year!
2015 Shred Event
MDDF can help
you go from
this…
to
this…
It’s Easy!
Destroy confidential documents with peace of mind and in compliance with State Board law.
We’ll notify your patients
Let MDDF issue your legal publication notice in The Denver Post for four (4) consecutive weeks (April 5, 12, 19
& 26) in accordance with the state board rule for only $80 per doctor name.
You may also have your practice name included for an additional $80.
Individual ads can cost up to $400, so this is a great deal. Sign up by March 24, 2015 using this form.
Join us for MDDF’s Annual Shred Event Drop-off Day, Saturday, June 6, 2015 – 9:00am - Noon
Shredding Trucks will be at Children’s Dentistry, 5150 W 80th Ave, Westminster, CO 80030. Each “banker-sized
box” (approx. 10”Hx12”W’15”D) costs just $7 to shred (larger boxes - $12), payable on-site only by credit card,
cash or check (payable to MDDF). 100% of the Shred Event proceeds benefit MDDF!
We can provide you with shredding options
If you allow us to post your legal notification, as soon as June 1, 2015 you may begin destroying inactive patient records
that are dated prior to May 1, 2008.* In partnership with Shred-it, we offer three economical options – one-day drop-off
event, one-time pick-up or discounted monthly services. Choose a low $95 one-time rate to shred up to 450 lbs. (about 15
boxes) or monthly ongoing service starting at $48 per month. Call Bill Bradford at Shred-it directly at 303-514-8596 to make
arrangements. Be sure to tell them you’re an MDDS member to qualify for discounted rates!
Yes! I want to be included in MDDF’s legal notice that will be published in the Denver Post. Please complete this section
and provide addresses for any additional office locations. Email & mailing address (including zip code) required for Credit
Card payment. Please call Amy at 303-957-3272 with any questions.
Dr. Name:
Day Phone #:
Office Address:
City:
CO Zip:
Email:
My check to MDDF for $80 per Name is enclosed; OR please charge my:
Name on Card:
Card #:
AmEx
MasterCard
Exp Date:
VISA
Billing Address (if different):
City:
CO Zip:
Signature:
If paying by check, please mail completed form & check to MDDF, 925 Lincoln Street, Unit B, Denver, CO 80203.
If paying by credit card, please email completed form to aboymel@mddf.org or fax to 303-488-0177.
Registration deadline is March 24, 2015 – NO EXCEPTIONS! No refunds or cancellations after this date.
*MDDF does not give advice as to which records may be destroyed. Each individual dentist and dental practice must make
that determination. A copy of the Colorado regulation relating to Patient Records Retention (3CCR 709-1) is posted on the
MDDF website for your convenience. If you have questions, please consult legal counsel.