New Patient Forms & Information

New Patient Information Form

Financial Policy

We are happy to have you as a patient and look forward to offering you and your family the finest dental care available. We know that providing comprehensive dental services include discussing all treatment and financial information. Before Treatment is performed we will discuss treatment and financial options. This will help you to fully understand your dental treatment, what to anticipate in fees and allow you time to make the necessary financial arrangements. Payment is due at the time services are rendered. For your convenience we accept cash, checks and all major credit cards. We also accept Care Credit, which may also be available to you.
* A returned check fee of $35 will be added to your balance and must be paid immediately.

Cancellation Policy and Failed Appointments

Appointments are reserved exclusively for you. We reserve the right to charge and collect $50.00 for any failed appointments. Failed appointments are considered those that are missed are cancelled with less than 48 hours advance notice.

Emergency After Hours

Emergency after hours patients are expected to make payment in full. We will then file a claim to your insurance and issue a refund if applicable.

Insurance Policy

Dental Insurance Plan benefits are determined by you and your employer, not your dentist. Your dental plan policy is a contract between you and your company. Your plan and payment is your responsibility. A plan is not a guarantee of payment and at times will not cover all the costs involved in treatment. As a courtesy, we will be happy to help you research your plan and file your claims for you.

  • You will be expected to to pay for services rendered if we are unable to verify your insurance before treatment.
  • Any deductible or estimated co-payment amount will be due at the time of service.
  • If payment for services already rendered has not been paid in full within 30 days by your insurance plan, the remaining balance is considered due and must be collected from you.

We would like to take this opportunity to thank you for choosing our practice for your dental care.

Hours Of Operation

Lunch Hours: 12:00 PM - 1:00 PM


8:00 AM-5:00 PM


8:00 AM-5:00 PM


8:00 AM-5:00 PM


8:00 AM-5:00 PM







Contact Us Today!

We look forward to hearing from you.