On this sample
No form on Clearwater Family Dental sends data anywhere. The appointment request, the reading options and the checklist all run inside your browser.
Your text-size choice, contrast choice and checklist ticks are kept in local storage on this device so they persist between pages. Clearing site data removes them.
For a real clinic
Clinic's privacy notice goes here
Who the data controller is, the lawful basis for handling health records, retention periods, how patients request access, and how to complain to the regulator.