Patient History Form
Save time by filling out this form before your first visit! This form provides us with information about how to contact you, your medical conditions and your insurance coverage.
How we can assist you?
We understand you may have questions about us and we would like to give you some information you may find helpful and answers to frequently asked questions.
First of all, please feel comfortable and relaxed about asking questions. We are happy to answer questions regarding treatment, insurance or billing. Feel free to come by or call us regarding any question you may have.
Have your dental insurance information available when you call us to schedule an appointment and if you must cancel, please try to contact us at least 48 hours prior to the appointment time, if possible.
When you come in for your appointment please have x-rays and other pertinent information from your general dentist for us and, if you can, please request x-rays and information to be sent to us from your dentist ahead of time. This gives us adequate time to prepare for your visit and we can accommodate for various medical conditions, medications and histories of medical needs. Of course, we will need your medical doctor’s name and address for our files, too.
Also, please keep in mind, patients with dental insurance should realize the services rendered are to the person and not the insurance company. This means the insurance company is responsible to the patient and the patient is responsible to the doctor. We cannot render services on the assumption the charges will be paid for by the insurance company, but we will help in every way possible by filing the claim and handling insurance questions from our office on your behalf. Last, but not least, please bring your insurance card to the consultation visit so we can take down the information and expedite your claim.
We request your consultation visit be paid for at your appointment time unless other arrangements are made ahead of time.
We use the latest technologies to find accurate diagnoses and treatments and for your comfort, we offer laughing gas and tranquilizers.
We have a lending library which provides information on a variety health related matters.
Our philosophy is to provide you with the most up-to-date quality care and we strive to minimize complex and expensive treatments if there are other ways we can achieve your desired result. We look forward to meeting you and will work with your general dentist to help you achieve optimum oral health.