Payment/Forms

Deductibles, copays and/or coinsurance amount is due at the time the service is rendered.  We will bill your insurance, however it is your responsibility to know what your insurance covers.  Please remember, since dental care is given only by private contract between the doctor and the patient, responsibility for payment is yours alone as you are the person who received the care.  As a courtesy, we will file your primary claim for you.

We accept:

Patient Forms

New patients will be asked to fill out a Health History, a Notice of Privacy Practices, and a copy of the Privacy Practices is available.

Click here to download our Health History Form.
Click here to download our Fee Authorization & Privacy Practices Acknowledgment Form.
Authorization for Release of Dental Information (form coming soon)
Privacy Practice (form coming soon)