Dental Office
Policies
PATIENT REGISTRATION FORM
A detailed REGISTRATION FORM is required of all our patients. This
permits us to accurately file your dental benefit claims, to contact
you, and follow-up should the need arise. Please inform us of any
changes to the information you initially provided.
HEALTH HISTORY
An extensive health history is required because we are concerned
with your health. Many systemic conditions/diseases effect how your
treatment is planned and delivered to you. Therefore, we ask that
you complete our HEALTH HISTORY FORM carefully and fully upon your first visit. If the patient is Under 18, please use our SHORT FORM
SUGGESTION: If you take prescription medication,
make a list of the medication along with the dosage to carry in your wallet.
This not only helps with our forms, but also aids emergency medical
personnel should the need ever arise.
CONSULTATIONS
All patients receive a treatment and financial consultation before
treatment is initiated. We will do our best to estimate your dental
benefits, if applicable.
CONFIRMING APPOINTMENTS
Our appointments are confirmations! We have reserved that time exclusively
for you. At your request, we will be happy to give you a courtesy
call.
CANCELLATIONS/RESCHEDULES
We require 48 hours notice to reschedule or cancel your appointment.
Any broken appointments or last minute cancellations will be charged
a $50 non-refundable fee. We understand that emergencies happen, so please keep us informed if you have to reschedule.
More Dental Evaluation Forms >>
