Information For New Patients

Book Your First Appointment

Name: *

Phone Number:

Email Address: *

Have you visited us before? *

No, I am a new patient. Yes, I am a returning patient. Other

How did you hear about us? *

Online Search Social Media Advertisement Referral Other

Message: *

Spam Blocker:

How long will your first visit take?

We understand the value of your time.

If you wish to save time in the office, you can download and complete the forms below and bring them with you on your first visit.

If you do not wish to complete the forms ahead of time, we recommend that you arrive 15 minutes prior to your appointment time, to complete the patient information and medical history forms.

Patient Information Form* | Dental and Medical History Form*

*IMPORTANT: Any form submitted by email must be encrypted, to ensure it is secure. By submitting an unencrypted email form, you are consenting to an unsecured email. Alternatively, please print off the form, complete it, and bring it to our office.

Fees

It is the patient’s responsibility to pay the fees for their dental services. We accept the following methods of payment: Visa, MasterCard, American Express, Debit and Cash are accepted.

Insurance Claims

Our office will submit your dental insurance claim on your behalf, and you will receive reimbursement from your insurance provider based on the coverage that you have.

Your dental treatment plan can be submitted to your insurance company before proceeding with any major dental treatment to determine the estimated amount your plan will pay for the proposed dental services.

Please contact us if you would like any additional information.