New Patients

Your First Visit:

You can expect to receive a thorough examination and careful evaluation of your oral health, including necessary x-rays, and a discussion of the most satisfactory treatment plan to meet your oral health needs. Please read and completely fill out the new patient forms and bring them to your first visit. We also need you to bring your dental insurance card. Remember that you are responsible for full payment at the first visit.

*Please plan to arrive 10 minutes prior to appointment time.

Payments and Insurance:

Patients with Dental Benefits: As a courtesy to our patients who have dental benefits, we are happy to file your claims electronically from our office. Under most circumstances, we do require at least a partial payment towards services at the time the services are rendered. For “restorative” treatments (Ex: fillings), we require at least 30% of the treatment total. For “major” treatments (Ex: crowns, bridges, extractions, root canal treatment), we require at least 50% of the treatment total. For any preventative and/or diagnostic services (Ex: prophylaxis, diagnostic films, exams), we do not require any payment at the time services are rendered. Please understand that it is your responsibility to know your specific plan/policy’s coverage. Your dental benefits may cover less or more than what we estimate or collect from you initially. Therefore, after we receive payment from your dental benefits provider, there may be a balance leftover which we will send you a statement for requiring you to pay within 30 days; or, there may be a credit leftover. If the credit is $10 or more, you should receive a reimbursement from us within 10 business days. If the credit is less than $10, we will apply it to your next visit unless you contact us requesting a reimbursement check.
Patients without Dental Benefits: Patients without dental benefits are required to pay in full at the time services are rendered.

Care Credit Payment Options:

We understand that regardless of whether or not a patient has any dental benefits, care, maintenance and treatment are necessary to maintaining good overall health; but medical expenses can be unexpected and costly. That is why we are happy to be able to offer all of our patients the advantage of the Care Credit patient payment plans. With their high acceptance rate, these plans offer no interest (up to 12 months) and low interest (up to 60 months) payment plan options to almost everyone.

You can submit an online application at www.carecredit.com  or submit through their automated phone application at (800)365-8295. You will receive a decision immediately.

New Patient Forms:

For your convenience all the forms that will be needed for your first visit may be downloaded. Complete them at home and bring them with you to the consultation appointment.

• Patient Information/Insurance Form
• Medical History
• Dental History
• Practice Policies
• Receipt of Privacy Practice
• Notice of Privacy Practices

Please download Adobe Acrobat below to view/print forms: