Patient Info

Patient Information

When scheduling your first appointment, please notify us regarding any medical condition that may be of concern (e.g.: diabetes, high blood pressure, artificial heart valves and joints, mitral valve prolapse, rheumatic fever, etc.), or any medication you may be taking (e.g.: heart medications, aspirin, anticoagulant therapy, etc.).

Your initial appointment will consist of a comprehensive oral evaluation, cancer oral screening, periodontal records, and intra-oral pictures.

On your second visit, you will meet your designated hygienist for recommended hygiene treatment. A personalized treatment plan presentation will follow, explaining your diagnosis and treatment options.

Frequently, in the case of emergencies, treatment can be done the same day.

Please assist us by providing the following information at the time of your consultation:

  • Your referral slip and any current X-rays, if applicable
  • A list of medications you are presently taking
  • Your insurance information, if applicable

To save time, we encourage you to download, print, fill in, and sign the following documents in PDF (Acrobat Reader – get it here) format:

To download, right-click and "Save Target As..."

To download, right-click and "Save Target As..."

IMPORTANT: All patients under 18 must be accompanied by a parent or guardian during the consultation visit.


We make every effort to schedule your appointment at the most convenient time.

Our offices places one courtesy call 2-7 days prior to the date of service. You are ultimately responsible for your appointments. If we are unable to reach you in person, we will leave a message requesting a return call to confirm your appointment. Unfortunately, if our office does not receive confirmation, we will be unable to honor your appointment.

We understand that, at times, circumstances arise that prevent patients from keeping their appointments. In such situations, we request advance notice, so that we may offer the time to another patient who needs it.

Financial Policy

All payments are due in full at the time services are rendered. We also offer no-interest and low-interest financing through an outside company for those who qualify. We will gladly accept a personal check.

However, checks returned to us by the bank for any reason will be subject to a $25 fee.

We also accept all major credit cards.


It is important for you to understand that the contract regarding your dental benefits is among you, your employer, and your insurance company. Your obligation to our practice is to pay for the treatment, regardless of the amount that may or may not be reimbursed by your insurance company.

Our office will accept payment directly from your insurance company with the following provisions.

Although we are willing to complete insurance forms and submit claims on your behalf, we do not accept responsibility for the outcome of the transaction. Completing insurance forms is a courtesy we extend to you in an effort to maximize your insurance reimbursement. It is important that you understand that this does not eliminate your financial obligation to us for your treatment.

If applicable, you will be required to sign document(s) authorizing your insurance company to make payments directly to our office.

Our office makes no guarantee that your insurance company will pay for any treatment you receive from this practice, or what amount it may pay. We perform routine insurance billing procedures upon verification of your coverage. However, if your claim is denied, or paid at a lesser amount than anticipated, you will be responsible for paying the full balance at that time.

Our office will not enter into a dispute with your insurance company over any claim, although we will provide any necessary documentation you or your insurance company requests to sort out any questions or confusions that may arise. We will cooperate fully with the regulations and requests of your insurance company.

It is ultimately your responsibility to resolve any type of dispute over payments made or not made by your insurance company.