Patient Forms

New Patients Are Always Welcome

BEAUTIFUL SMILES IS GOING GREENER!

Help us reduce paper use and fill out your forms online! So convenient too!

To preserve our environment and make things easier and more convenient for our patients, we have made all of our new patient forms available to you online. When you click below you will be directed to a secure website where you may fill out and submit your new patient forms. Please complete all forms prior to your appointment.  Thank you!

HIPAA: Notice of Privacy Practices

Acknowledgement of Privacy Practices

Patients enjoy the individualized attention they receive from us. We want to make sure you are comfortable and understand the dental treatment recommended. We take pride in our care, skill and judgment and in our ability to provide a pleasant dental experience that leaves you feeling good about yourself, your smile and your total health.

Ask us about music, movies, pillows, and our hand warmers, etc. – it is our pleasure to see that you have the most comfortable dental visit you have ever experienced!

Our office staff will be happy to assist you in the scheduling of your visit.

Hours of Operation

Our usual hours are Monday, Tuesday and Thursday from 7:00 a.m. to 5:00 p.m, Wednesday is by appointment and Friday 8:00 a.m. to 3:00 p.m. During the winter, we take most Wednesdays off, often because we are attending monthly continuing education courses, and during the summer, we take most Fridays off. Feel free to ask our office staff about the current schedule and they will be happy to assist you in setting up your appointment.

Referrals

We welcome your referrals of family and friends. This is one of the highest compliments you can give us. We look forward to this opportunity to take great care of those you send to our office.

Insurance Questions

We believe that health care decisions should be in the best interest of the patient and not dictated by what an insurance plan may pay towards the cost of your care. Some policies have restrictions that may limit the dental care choices available to you.

We accept those dental insurance plans that are fee for service, including Anthem Blue Cross and Delta Dental plans. Please check with us to see if we work with your particular insurance plan. Many PPO and DMO plans have out of network provisions that you can use to your advantage.

Our business team is happy to answer any insurance questions that you may have.

Payment Options

Patients can pay by cash, check and all major credit and debit cards, including Discover, Visa, MasterCard and American Express. We also have a dental patient financing program to help patients extend payments when necessary. We are proud to work with Care Credit for well over a dozen years. Care Credit has plans with  0% interest options that may appeal to you.  Please feel free to explore this option at  www.carecredit.com.  We will be pleased to discuss the payment options with you at your visit.

Appointment Cancellations

We reserve your appointment time exclusively for you. In the event that you need to change an appointment, please give us at least two business days advance notice so that we may offer that time to someone else who needs our care. No charge will be made for cancellation of appointment if two business days advance notice is given.