Information
If you are new to our practice please click on the following orange links to access PDF files to save time at your first visit:
- Health History Save time at your first visit by filling out this health history form accurately and completely.
- HIPPA The privacy of your information is important to us. This form outlines our responsibility to keep this information protected. Please read it carefully and sign on the second page.
- Records Release If you would like us to contact another provider to obtain treatment records just fill out this form to authorize the transfer. Please note that some practices charge a nominal fee for duplication of records.
Insurance We work with most insurance plans. We will prepare and file insurance claims for you. However, we consider our relationship with you to be our primary importance and make recommendations based on the very best treatment for you regardless of your insurance company’s “management”.
Estimated Co-Payment at Visit Estimated co-pays are expected at the time of service. Our front desk staff will assist you in determining your insurance benefit and your estimated portion so that your payment can be conveniently made on the date of your service. Cash, Check, Mastercard, Visa, and American Express are accepted forms of payment.
Interest-Free Payment Plans We believe it is important to not only provide the highest quality care, but to also make the care affordable. We make arrangements with our patients that allow payments to be convenient and flexible. We are committed to helping you receive the dental care you desire through financing that works with your needs. We have also obtained the services of a health care credit company that can arrange for interest-free payments that can be extended up to 18 months from the date of treatment. Our front desk staff can answer all your questions, and even help you apply, for this service. If you like you can visit their website for more information. www.carecredit.com