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PATIENT FORMS
PATIENT FORMS
Experience personalized care and support from our dedicated team on your journey to lifelong dental wellness. Enhance your visit by downloading and filling out our forms beforehand. Simply bring them along to your appointment for a smoother, expedited process.
01
New Patient Form
Got questions, concerns, or need to book an appointment? Reach out to us now. Conveniently fill out our online form.
02
Medical History Form
For inquiries, appointments, or any concerns, reach out to us today.
03
HIPPA Information
For inquiries, appointments, or any concerns, feel free to reach out to us.
04
Informed Consent Form & Information Form
Prepare for your first visit by downloading, printing, and completing our PDF form. Simply bring it with you when you come in.
05
Patient Information &
Office Policy
Prepare for your first visit by downloading and completing our PDF form. Simply print it, fill it out, and bring it with you.
06
Notice & Privacy Practice
Prepare for your first visit by downloading and completing our PDF form. Simply print it, fill it out, and bring it with you.
Referral Form
Prepare for your first visit by downloading and completing our PDF form. Simply print it, fill it out, and bring it with you.
FINANCIAL ARRANGEMENTS
AND DENTAL INSURANCE
FINANCIAL ARRANGEMENTS AND DENTAL INSURANCE
Our payment policy ensures seamless service: we kindly request payment at the time of your appointment.
We accept various payment methods including cash, personal checks, Visa, MasterCard, Discover, American Express, Care Credit, Sunbit and Apple Pay.
Seniors without insurance enjoy a 10% discount on our services. For your convenience, we handle insurance filings and ask that you settle your portion at the appointment. Should you have any queries, our office assistants are readily available to assist you.