New Patient Info Test Page
If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions at all.
Patient Registration Form
HIPAA
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Payment Options
For your convenience, we accept cash, personal checks, money orders, major credit cards (Visa, Mastercard, Discover) and CareCredit. Payment is expected at the time services are performed. When more extensive dental care is necessary, financial arrangements can provided through CareCredit.
Insurance
As a service to our patients, our practice accepts most dental insurance programs, including non-managed care, indemnity (traditional) and PPO out-of-network. We are not part of any managed care network. 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.
Care Credit
As a service to our patients, we are pleased to offer the CareCredit card, the nation's leading patient payment program. With CareCredit you can finance 100% of your dental care and there are no upfront costs, no annual fees, and no pre-payment penalties. So, you can begin your treatment today and conveniently pay with low, monthly payments.
CareCredit offers a full range of payment plans so you can find one that works best for you. With the popular No Interest Payment Plans* there are no interest charges if you pay your balance in full within the specified time period. Monthly payments can be as low as 3% of your balance. For procedure fees from $1,000 and up, CareCredit offers 24, 36, or 48 month plan options with low monthly payments available.
CareCredit can be used by the whole family for ongoing treatment without having to reapply. And by using CareCredit for your dental care, you can save your other credit cards for household or unplanned expenses. It only takes a few minutes to apply for CareCredit and you'll receive an online decision in seconds! Apply Now or see our staff for more details.
* terms and conditions
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