Patient Forms

New patients can save time by filling out the forms below and bringing them to their appointment.  

New Patient Paperwork


To view a copy of our office's Notice of Privacy Practices (HIPAA), please click here.


If you have dental insurance, we would be more than happy to submit claims to your insurance on your behalf, regardless of network participation.  If your insurance plan does not pay our office directly, we would expect payment at the time services are rendered. If your insurance has notified us that you will have a copayment for your treatment, then your co-pay will be expected at the time of service. Patients are ultimately responsible for all charges incurred, regardless of insurance status.

Our office participates with the following insurance networks:

  • Delta Dental Premier

  • United Healthcare Dental PPO

Payment Methods

Payment may be made by personal check or credit card. We accept Visa, Mastercard, Discover, and American Express.

Financing through CareCredit

CareCredit is an easy, convenient way to pay for the care you need today, without spending cash upfront. With deferred interest for up to twelve months, CareCredit is ideal for treatment that is not covered by dental insurance, such as cosmetic procedures. CareCredit makes the treatments and procedures you want possible today while allowing you to focus on what's important - a beautiful, healthy smile!