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Patient Information

New Patient Forms

FormThe New Patient Forms are in Adobe Acrobat (PDF) format. If you do not have Acrobat Reader, get a free copy by clicking on the link below.

Adobe Reader

Please print the appropriate New Patient Form, fill it out, and bring it with you for your appointment.

Adult New Patient Form Child New Patient Form

 


Insurance:

Dental insurance is intended to cover some, but not all of the cost of your dental care. Most plans include coinsurance provisions, a deductible, and certain other expenses which must be paid by the patient at the time of services. Reimbursement amounts are not, and never have been, a guideline for quality care.

We can file most insurance claims for you. Please bring your insurance plan information with you on your first visit. We will work with you to ensure that you receive the maximum benefits to which you are entitled.

Payment:

We accept cash, checks, VISA, MasterCard, Discover, American Express and debit cards. Extended terms are also available through Care Credit. You can apply in our office or apply online.

MasterCard
Visa
AmEx
Discover
Care Credit

 

If you have any questions about your insurance plan or payment options, please call us at
(513) 523-7515.