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Patient Info

Patient Info

Patient Information

Patient Forms

Welcome, new patients! To save time at your visit, we have provided the forms below. Please print and fill out each form to bring to your first appointment. If you have any questions, please let us know.

PATIENT REGISTRATION

MEDICAL HISTORY FORM

AMENITIES PREFERENCE


Information

Please be sure to familiarize yourself with the following prior to your appointment.

PRIVACY PRACTICES

DENTAL INSURANCE INFO


Payment Options

Dental treatment is an excellent investment in an individual's well being and we make every effort to make finanancial arrangements a comfortable experience. To help keep costs of dental care down, and to continue to provide quality care to our valued patients, we now accept payment in full, the day of treatment.

We accept the following payment options:

  • Cash/Check

  • Visa

  • MasterCard

  • American Express

  • Extended payment plan, Care Credit (please see receptionist for application form)

PAYMENT OPTIONS FORM PRINTOUT