Patient Forms
NEW PATIENT FORMS
Please complete this form before your first appointment. Filling it out beforehand will save you time during your appointment. Please make sure you complete the full form.
No insurance? See our discount plan.
1. ADULT CONSENT FORM
If you need your child to be brought by someone different than you to their appointment, please make sure you fill out this form and sign it so we can proceed with their cleaning or treatment. This person can be informed of what it's being done to your children but they cannot make decisions about your children's treatment.
2. DENTAL INSURANCE INFORMATION
We are happy to estimate dental insurance benefits, file claims on behalf of our patients, and follow-up with claims filing/billing.
Should you have any questions or concerns regarding your dental coverage with us, please call our office! We are happy to help find out about your benefits if you are unsure what your coverage allows.
3. OFFICE & FINANCIAL POLICY
It is our goal to provide quality dentistry for your child in a professional, relaxed and friendly atmosphere, and we strive to meet these goals daily. This letter states some office policies that we feel are important in maintaining a positive relationship.