Patient Forms
For your convenience, we have made our Patient Profile form available to you as an Adobe Acrobat Reader (PDF) file so that you have the option of printing and completing it in the comfort of your home.
Please remember to bring your completed form with you for your first appointment. If you do not bring the completed form with you, you will have the option of completing it when you come to the office.
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If your computer cannot open PDF files, you can download a free version of Acrobat Reader from Adobe's Web site. |
Financial Arrangements
Our fees are competitive with other providers of high-quality dental care in this area. It is our office policy to receive payment for services at the time of service unless other arrangements have been agreed upon. We accept personal checks and VISA, MasterCard, American Express, Discover, and cash, of course.
If you have dental insurance, you can expect us to help you get the maximum benefit to which you are entitled. We are a participating dental office for the following insurance plans:
- Delta Dental Premier
- Horizon Blue Cross/Blue Shield
- Cigna
- Aetna Dental PPO and PDN plans
- Aetna Affordable Health Choices
- Aetna Dental Access and other plans
If you have other types of dental insurance, we will accept assignment of benefits for most plans. However, fees for some services may not fall within a particular plan's definition of "usual and customary," and you will be responsible for the difference.
In the event your planned treatment will result in fees exceeding $2,000, we may consider a mutually acceptable schedule of payments to assist you with budgeting.
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