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Forms & Polices

Welcome to our practice! Thank you for the trust you have shown in us by choosing our office for your dental care. In order to familiarize you with policies and payment plans offered, they are listed below. Our commitment is to provide the best possible service. Please don’t hesitate to ask if you have any questions.

OFFICE HOURS:

Monday – Friday
8am – 5pm with lunch typically at noon

Please give us at least 48 hours’ notice if you are unable to keep your dental appointment. Giving us at least 48 hours’ notice allows us time to make a new appointment for you and give your original one to another patient. It also allows us to see our patients on time and helps us give more affordable dental care for all of our patients.

Your dental insurance is a contract between you and your insurance company. We accept almost every dental insurance and can provide an estimate of insurance coverage along with your treatment plan as a courtesy to you based on information that we are given by your insurance provider (please bring your current insurance card to your appointment for verification purposes). The estimated portion not covered by insurance is due the same day that service is provided. Your plan may tell you that they will only pay benefits for the least expensive alternative treatment for a condition, or deny coverage for conditions that existed before you enrolled in the plan. In addition, many plans do not provide coverage for all dental procedures. This does not mean that these procedures are not necessary – it just means that your plan does not cover them. Because we cannot guarantee payment by your insurance company, any portion not covered by insurance is your responsibility.

If you would like a more accurate estimate, you may request that we submit a ‘preauthorization’ form to your insurance company prior to treatment. As a service to you we will file your insurance claim for you, but after 60 days of nonpayment you are responsible for the entire balance.

For patients with no dental insurance, payment is due the day of service ‐ unless previous arrangements have been made. The estimated portion not covered by insurance is due the same day that service is provided. Visa, MasterCard, cash, and checks are accepted. We also accept payment plans exclusively through CareCredit and can help you with the application process in the office.

For services that involve a lab (crowns, bridges, partials, dentures, etc), half of your portion will be due the day that teeth are modified or master impression is sent to lab. The other half will be due the day the procedure is completed unless previous arrangements have been made.

Delinquent balances (over 30 days) will have a late charge of 18% annually (1.5% per month).

Please call office phone number for the most current information provided based on the current week (ie doctor on call, phone numbers to contact, vacations, closures, etc.)

We will be closed on most major U.S. Holidays (Christmas, Thanksgiving, New Years, Independence Day, Memorial Day, and Labor Day)

Patient forms

All of our required forms for new patients are available right here on our website! Just download, print, and fill them out on your own time, and bring them to your first appointment along with your insurance card (if applicable). For your convenience, we also offer electronic forms that you can complete directly online:

New Patient Forms (English): Click here
New Patient Forms (Spanish): Click here

DOWNLOAD FORMS IN ENGLISH
DOWNLOAD FORMS IN SPANISH