Patient Information

New Patient Forms

Save time, take care of the paperwork now.

Our New Patient Forms are now available for download so that you can complete them at your convenience. This gives you the time you need to carefully review our policies and procedures outside of the office and makes your first visit easy.  Click on the links below to download the forms.  Print the forms, fill them out, and bring them to your first appointment.

• New Patient Forms
• HIPAA Form
• Release Authorization Form
• Opioid Alternatives Form

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Scheduling

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Financial and Payments

We are committed to providing quality and affordable dental health care. You have multiple options for payment available. For your convenience we accept cash, check money orders, major insurance, Visa, Mastercard, Discover, and American Express.

For larger treatment plans we are pleased to offer CareCredit with no interest payment options. Please click on the logo for more information. We will work with you to fit quality care into your budget through financial arrangements or by staging treatment over time. Like most things do not be afraid to communicate your situation.

Payment is required at the time services are performed. Other financial arrangements are available when extensive dental care is necessary, or when the dentistry performed exceeds your budget or insurance benefits. We will be sensitive to your financial circumstances within the framework of sound business practices.

We deliver the finest care for our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance. Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage.

Financial arrangements need to be made prior to treatment to avoid any misunderstandings.

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If you have questions regarding your account, please contact us at (850) 477-5252. Many times, a simple telephone call will clear any misunderstandings.

We understand that unexpected dental bills can strain finances. If this happens to you, don't hesitate to call us at (850) 477-5252. If you keep the line of communication open with us, we will be able to work out an acceptable arrangement.

For questions about payment and financing, please contact our office. We are happy to help!