Patient Forms

EXISTING PATIENTS

Please fill out the following:

-Updated Medical History

-COVID-19 Prescreening

We make it convenient and easy for you to complete our patient forms. Please fill them out in their entirety before your scheduled appointment.

Insurance & Financial Policies

Ability to pay is of deep concern to many dental patients. We share your concern and are prepared to offer you a number of payment options. Payment is due at each appointment. We accept cash, checks and most major credit cards. We will discuss the payment plan best suited for you in privacy and assist you with all the arrangements.

Your insurance coverage is an agreement between you and your insurance company. All insurance benefits are determined by your employer, not your dentist. Upon scheduling an appointment, it is the patient's responsibility to provide us with proof of insurance, such as an insurance card. It is also the patient's responsibility to provide us with any changes to insurance plans.

We will verify your dental eligibility as well as estimate your deductible and your portion of the fees. Your portion is due on the date that services are provided. As a courtesy to our patients, we will file your PPO insurance, however we do not verify benefits. If you are not sure what your benefits are, please contact your insurance company.

We offer an exclusive membership program for all our patients. If you have PPO insurance, we file claims as a courtesy for our patients.