New Patient Forms
Please click on the appropriate forms below as instructed by a member of our team. These forms may be filled out online, or completed at our office. If you choose to complete the forms at our office, please arrive 20 minutes prior to your appointment to allow adequate time to complete the forms. If you ever have any difficulty with opening or filling out the forms, please contact our office. We will gladly assist you.
If you have insurance, please have your card ready at time of scheduling. If you do not have insurance, check out our dental savings plan here
Our New Patients Forms:
Click Here to view our very affordable Dental Savings Plan.
Patients
Questions about our use of Fluoride? Check out this link for all the information.
Pay your bill online!
Simply pay the amount you owe and that will be instantly applied to your account. If you ever have any difficulty with the payment process, please contact our office. We will gladly assist you.
Appointment Cancellation Policy:
We strive to render excellent dental care to you and the rest of our patients. In an attempt to be consistent with this, we have an Appointment Cancellation Policy that allows us to schedule appointments for all patients. When an appointment is scheduled, that time has been set aside for you and when it is missed, that time cannot be used to treat another patient.
Our policy is as follows:
We require that you give our office 48 hours notice in the event that you need to reschedule your appointment. This allows for other patients to be scheduled into that appointment. If you miss an appointment without contacting our office within the required time, this is considered a missed appointment. A fee of $25-100 or percentage of the treatment cost will be charged to you; this fee cannot be billed to your insurance company and will be your direct responsibility. No future appointments can be scheduled without the payment of this fee.
Additionally, if a patient is more than 20 minutes late without prior notice for a scheduled appointment, we will consider this a missed appointment and the $25-100 cancellation fee will be charged.
If you have any questions regarding this policy, please let our staff know and we will be glad to clarify any questions you have. We thank you for your patronage.
I have read and understand the Appointment Cancellation Policy of the practice and I agree to be bound by its terms. I also understand and agree that such terms may be amended from time to time by the practice.