Patient Information

New Patient Paperwork

For each new patient, please fill out, print and bring the following forms with you to your first appointment. We can also mail forms to you if you’d prefer. Please call our office to make arrangements. If you are unable to do so, please arrive 15 minutes prior to your appointment to fill out the necessary paperwork.

Privacy Practices

‍The following form is optional to print and is for your reference only.

Fees & Payments

We make every effort to keep down the cost of your dental care. You can help by paying at the time of your visit. If your treatment program requires several visits, you will be given an estimate and asked to discuss definite financial arrangements with a member of our business office staff.

For your convenience, we accept the following payment methods:

  • Cash
  • Visa
  • MasterCard
  • Discover
  • American Express
  • CareCredit *
  • Checks

*CareCredit is our financial partner that offers no interest or extended payment plans.



We follow a program which simplifies the preparation of insurance claim forms, thereby holding down the office costs that are unrelated to the delivery of good dental care. We are a preferred provider for Delta Dental and our office offers to submit your insurance claim form as a service to you.

Please remember that no insurance company attempts to cover all dental costs. Some companies pay fixed allowances for certain procedures and others pay a percentage of the charge. It is your responsibility to pay any deductible amount, co-insurance or any other balance not paid for by your insurance company on the day of your appointment.

We know questions can arise on insurance matters. We encourage you to discuss such questions with our business office staff. We will be happy to help you receive the maximum benefits; however, the agreement of the insurance company to pay for your dental care is a contract between you and the company.