Downloadable Patient Forms
We have provided a convenient way for you to fill out your new patient forms before your office visit. Please click on the links below to download each form. Print the forms and fill them out to present at our front office when you arrive.
New Patient Forms Download Center
- New Patient Form
- Notice of Privacy Practices
- Receipt of Privacy Practices
- Consent for Use and Disclosure of Health Information
Our office will work diligently on your behalf with most dental plans and gladly file your claim in order to maximize your benefits. Co-payments and deductibles (the portion the insurance does not cover) are due at the time services are rendered. In order to process claims properly, patients must provide us their correct and appropriate insurance information and inform us of any changes regarding their dental insurance at the time of service. Please keep in mind, most dental insurances do not cover cosmetic procedures.
Our office is dedicated to making your services as easy and affordable as possible. We feel that it is very important for everyone we see to be educated and informed about the procedure that they are interested in.
Financial planning for what can be a substantial purchase is important and we would like you to be well-informed about the cost and payment options that are available to you. That is why we have provided some helpful information to assist in deciding which form of payment will work best for you and your individual needs.
Whether you have been saving for a while, plan on using a low-interest credit card or just need some direction in choosing the finance company that will fit your situation, we are here to help.
Forms of payment accepted:
- Credit Card (VISA, MasterCard, American Express, DISCOVER)
- Debit Card
If any of the above forms of payment are not options for you at this time, we also offer financing through an outside company called Care Credit. They specialize in financing dental procedures and follow their own specific guidelines. Below is a link to Care Credit. You may fill out their application online.