Insurance & Forms

Insurance & Patient Forms

For the convenience of our patients, we file all insurance claims on the day of treatment. We try to help you utilize your maximum benefits. We also have other payment options including MasterCard, Visa, Discover Card, and American Express. Deferred interest financing through Care Credit is also available.

Patient Registration Form

Medical History Report

HIPPA Form

Smile Assessment

Safety

Safety for our patients and our staff is one of our top priorities. That is why the office meets and exceeds all OHSA (Occupational Health and Safety Administration) and CDC (Center for Disease Control) for infection control with our new state of the art Sterilization Center.