Patient Information

SCHEDULING

First, let us welcome you to our office. Our aim is for you to have the most cultivated and pleasant experience possible. If you need anything from us, do not hesitate to ask.

To expedite your appointment, we have made some forms available to Download, Print, Fill-out and to bring on the date and time of your appointment. In addition, in the Preventative and Treatments sections we have provided some helpful information that can help you better prepare and understand your oral care and treatments.

If applicable, please provide: a list of medications you are currently taking and a list of drug allergies.

*A parent or guardian must be present at the consultation visits and treatment appointments for ALL patients under the age of 16.

Depending on the circumstances and availability treatments may be able to be scheduled on the same day as the exams.

Our office is equipped with complete digital radio graphic capability. We encourage patients and provider offices to forward any images to us electronically or by mail. Any document sent should include: the patient’s first name, last name and date of birth.

New Patient Onboarding form

Records Release Form

New Patient Intake

FINANCIAL POLICY

Full payment is due at the time of service unless prior arrangements have been made. If you have insurance deductible and co-payments are due at the time of service.

Patient is responsible for all fees incurred in the office. Any service not covered by insurance will be at the responsibility of the patient. We understand that the financial aspects of healthcare can be difficult to understand and confusing. Our office will try to do everything we can to help you.

You will receive a monthly statement. Please call our office if your statement does not reflect your insurance payment. Most insurance companies make payment within 4-6 weeks. Any remaining balance after your insurance has paid is your responsibility. There will be a 1% monthly interest charge (12% per annum) applied monthly to any account balance exceeding 60 days, regardless of insurance status. If your account becomes delinquent and it is referred to a collection agency

For your convenience we accept: CASH, CHECKS, CARE CREDIT or CREDIT CARDS (Visa, MasterCard, Discover and American Express). Please contact us with any questions regarding your account. We appreciate your timely remittance.