Appointment Request
New patients, please fill out this form to request an appointment with one of our dentists.
Forms & Downloads
The following downloads are provided in Adobe PDF format.
New Patient Registration
Dental History
Patient Health Record
Office Financial Policies
Appointment Policies
Notice of Privacy Practices
Acknowledgement of Receipt of Notice of Privacy Practices
Payment Options
We accept Mastercard, Visa, and Discover credit cards.
In-office financing plans available for up to three month terms.
Care Credit financing plans for financing greater than six months is available. Please inquire.
Insurance
All Major Fee-for-Service Insurance accepted and filed for the patient by our office.
Blue Cross Blue Shield
(Preferred Provider)
Delta Dental
(Premier, Premier Plus)
United Concordia
Cigna DPPO