Insurance and Patient Forms

Patient Forms

Please print and complete these two forms. Then bring them with you to your first appointment. Having these filled out a head of time will save you some time.

• New Patient Form
• Medical History Form

Insurance and Medicare

We would love for you and your family to be our patients. We will be happy to file all insurances. We do participate with some Delta Dental Plans as well as United Concordia. In order to use another type of insurance, you must be in a PPO not an HMO or DMO. A PPO allows you to see any dentist you prefer. A HMO or a DMO mandates that you must see a participating provider in order to use the insurance. We apologize that we do not accept medicare. Please call with any questions.

At both of our offices we will file PPO dental insurance even if we are out of network. Many insurances still pay 100% even if we arent on the list. Check with your insurance carrier to assess your dental plan. Some of the PPO plans include:

• Some Aetna PPO
• Some Cigna PPO
• Delta Dental Premier
• Decare (Anthem Complete)
• Some Guardian Plans
• United Concordia Active Duty

Other Payment Options

If you dont have insurance and need other payment options, you might want to consider CareCredit.