Patient Info

Patient Registration Form

Save time by completing your paperwork before your appointment. Download, print, and complete the patient registration form kit. Be sure to bring them to your next appointment.

Insurance Information

Our office is committed to helping you make the most of your dental insurance benefits. We accept most insurance plans and are a Network Provider for:

 

  • Aetna

  • Aetna Ameritas

  • Blue Cross Blue Shield (most in-network plans; please check with our front desk coordinator)

  • Careington Platinum PPO/POS and MaxCare Cigna DPPO Advantage and Radius

  • Delta Dental PPO

  • GEHA

  • Lincoln

  • MetLife

  • Principal

  • Renaissance

  • United Healthcare

 

Because insurance policies vary in coverage from plan to plan, we can only estimate your coverage in good faith, but cannot assure coverage due to the complexities of insurance contracts. As a courtesy to you, we will submit insurance claims. However, we ask that you pay the estimated patient portion at the time of service. We will attempt to help you receive full insurance benefits. However, you are personally responsible for your account. We encourage you to contact your insurance directly if your policy has not paid within 30 days.

Payment Information

Special Arrangements

Please ask a member of our staff and we will review our payment options to accommodate your financial needs. If special arrangements are needed, please speak with our Front Desk Coordinator, prior to receiving service.

Payment and Financing

Your dental treatment plan will include a breakdown of all applicable fees. We will inform you of all costs before treatment is administered. We accept debit, cash, check or credit (Discover, Master Card and Visa) payments.

We offer financing through Care Credit as an option, please speak with our Front Desk Coordinator to review your options and to apply for financing.