Please click on the link below to download the form:
For your convenience, you can complete the Registration Form before you come to the office. This will save you time checking in at your first visit. This form includes a detailed Medical History, so we can provide you with the best possible care. Secondly, it includes financial and Insurance information, so we can fill out your insurance forms and submit them for you.
Currently we participate with Delta Dental Premier Insurance. We work with most other insurance companies provided the patient is not REQUIRED to go in network. We currently have patients on over a dozen different plans including Aetna, MetLife, Guardian, Blue Cross/ Blue Shield, and United Concordia among others. Our office does our best to estimate insurance payments using our insurance software and the information given to us by the patient.
We work with Care Credit to provide financing options for patients. This includes no interest plans that allows our patients to get their work completed in a timely fashion and have their payments extended out over time if needed.