Patient Information

Patient Forms

New Patient Form

**Please note that form may only be submitted using Internet Explorer.

Insurance

We accept all dental insurances, but we are in network with the following carriers:

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• Delta Dental

• GEHA

• Metlife

• United Concordia

• Guardian

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Payment Types

Insurance, Personal Checks, All Major Credit Cards, Debit, Care Credit Financing Available

Care Credit is accepted at our office.  For qualified applicants, they offer interest-free financing for 3 months - 18 months.  Please contact our office, or visit www.carecredit.com for additional information. 

Financial Policy

A 10% courtesy is provided to patients paying in full by cash or check for procedures totaling $500 or more. Payment is due at the time of service.  The full balance is due at time of service for minor procedures.  For major procedures, 50% of balance is due the day the procedure is started and the remaining balance is due when he procedure is completed.

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We will file your insurance each time you receive treatment in our office.  If there is a co-payment for your treatment, it will be collected at your date of service.