Patient Forms

If you are a new patient to our office, the our New Patient Bundle below has online forms that will need to be filled out before you arrive at our office. 

New Patient Form PDF

HIPAA Form PDF

Accessibility Statement

Payment Options

For your convenience, we accept cash, personal checks, money orders and major credit cards, including Care Credit. Payment is expected at the time services are performed. When more extensive dental care is necessary, financial arrangements can be made with our office.


Insurance

As a service to our patients, our practice accepts most dental insurance programs, however we are unable to accept medical insurance, Medicare or DMD plans. 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 submit a pre-treatment estimate to your insurance company so that you will know what your 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.