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Forms, Insurance and Financial
New Faster Easier
After you've made your appointment, login using your name, birthday, and phone number, and add all your info.
Login Here after you have an appointment.
Your first name, last name, birthday, and phone must match our appointment book.
No need to print out the forms and bring them in, you can do it online. It's safe and secure, and your
information is for our office use only.
Forms
Financial and Cancellation Policy (pdf)
New Patient Form (pdf)
Privacy Notice (pdf)
Payment and Insurance
We will work with you to find the payment option that is right for you.
We have several financial policy options available for your convenience in receiving the proper dental care.
We have found that our patients appreciate knowing exactly what dental financial responsibilities they will incur. Therefore, we will inform our patients about our financial policies before we begin treatment. Knowing this ahead of time allows us all to arrange for the completion of necessary dental treatment.
Financial Options include Insurance, Cash, Check, Credit Cards, and Dental Fee Plan.
Insurance
To better serve you, we accept and file most insurance. This saves you from the hassle of dealing with the mountain of forms and paperwork that most insurance companies require. If you have dental insurance, we will ask you for an estimated payment at the time of your visit depending on the treatment you have received and your insurance coverage.
Credit Cards
Visa, MasterCard, Discover, and American Express are welcomed.
Payment Plans
Monthly payment plans are available through Capital One® Healthcare Financesm and Care Credit®. These services offer an easy way to finance treatment plans.
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