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Patient Forms

Appointment

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete an online appointment request.

If you are a new patient to our office, the links below contain our new patient forms that will need to be filled out when you arrive at our office.  If you bring the forms to our office completed, it will allow us to attend to you more quickly.  Thank you and please call our office if you have any questions or concerns.

 

Patient Forms 

If you are a new patient to our office, the links below contain our new patient forms that will need to be filled out when you arrive at our office.  If you bring the forms to our office completed, it will allow us to attend to you more quickly.  Thank you and please call our office if you have any questions or concerns.

In light of the Covid-19 pandemic, we have implemented the following policies for the safety of our patients and staff:

1. You need to submit the patient screening form (below) ON THE MORNING OF YOUR APPOINTMENT.

2. You must wear a face mask to the office

3. If you feel sick, please call to reschedule.


For the safety of our patients and staff, we also ask that all patients complete and submit paperwork online prior to coming to the office. If you cannot access the paperwork through the button below, you may complete pdf forms (below the button) and email the forms to us.  If you are unable to complete the paperwork electronically, please call our office and our staff will assist you.


 Payment Options

Payment Options

For your convenience, we accept cash, personal checks, money orders and major credit cards. Payment is expected at the time services are performed. When more extensive dental care is necessary, financial arrangements can be made with our office.

 
Dental Insurance

As a service to our patients, our practice accepts most dental insurance programs, including non-managed care, managed care, indemnity (traditional) and PPO out-of-network.  Our accounting staff will prepare all the necessary forms for your dental benefits. However, we remind you that your specific policy is an agreement between you and your insurance company. Please keep in mind that you are responsible for your total obligation should your insurance benefits result in less coverage than anticipated. Our staff will gladly submit a pre-treatment estimate to your insurance company so that you will know what your benefits will be, but available benefits may change between the time the estimate is received and treatment is completed. 

The fees charged for services rendered to those who are insured are the usual and customary fees charged to all our patients for similar services. Your policy may base its allowances on a fixed fee schedule, which may or may not coincide with our usual fees. You should be aware that different insurance companies vary greatly in the types of coverage available. Also, some companies take care of claims promptly while others delay payment for several months.  If your claim is not settled by insurance within 60 days, you will be responsible for full payment.  In the case that your insurance carrier makes a payment after you have paid out of pocket, you will be reimbursed for the amount that insurance paid.  

 

Please call our office if you have any questions about our payment options. 


We look forward to meeting you!!!