Patient Forms and Insurance Info

Don't be daunted by claims and forms. Our experienced staff can assist you with the paperwork involved in keeping your teeth and gums healthy. We act as your advocate and partner with insurance providers and take care that the administrative aspect of our practice is as efficient, streamlined, and customer-focused as the rest of our practice.

Patient Forms

Download, print and fill out the required form(s) below and bring to your appointment for faster check-in. Adobe Reader is required to view these documents. Don't have it? Get it here. It's Free.

Adult Patient Form (516kb PDF)

Child Patient Form (560kb PDF)

Insurance Info

Though we are not under contract with any insurance company, we will gladly file any dental claim. An estimated co-payment, where applicable, will be calculated and is payable at the time of service. Any portion not covered by insurance is the patient's responsibility.

For your convenience, we gladly accept Visa, Mastercard, American Express and Discover cards as well as cash and personal checks.