New Patient Info
If you are a new patient to our office, you will find below important files that will need to be filled out when you arrive at our office. Printing them and filling them out beforehand and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions at all.
- Patient Form (Adult) [PDF]
- Patient Form (Child) – English [PDF]
- Patient Form (Child) – Spanish [PDF]
- Health Information Portability and Accountability Act (HIPAA) Consent Form [PDF]
- HIPAA Privacy Notice (for your information only) [PDF]
For your convenience, we accept cash, personal checks, money orders and major credit cards. We offer flexible in-house financing with minimal down. Whatever your financial situation, we can make your new smile affordable!
As a service to our patients, our practice accepts most dental insurance programs, including non-managed care, indemnity (traditional) and PPO out-of-network. Our accounting staff will prepare all the necessary forms for your dental benefits. However, we remind you that your specific policy is an agreement between you and your insurance company. Please keep in mind that you are responsible for your total obligation should your insurance benefits result in less coverage than anticipated. Our staff will gladly provide you with a pre-treatment estimate and determine what your insurance benefits will be.
The fees charged for services rendered to those who are insured are the usual and customary fees charged to all our patients for similar services. Your policy may base its allowances on a fixed fee schedule, which may or may not coincide with our usual fees. You should be aware that different insurance companies vary greatly in the types of coverage available. Also, some companies take care of claims promptly while others delay payment for several months.