Patient Information

Registration and Medical Forms


We have provided the forms below as a convenience to save you time when you arrive for your appointment.

Click on the form below to download your registration and medical forms. Please complete and sign them before your visit.

Patient Form
Dental History
Medical History

Financial Policy


Insurance Companies our office is contracted with:

  • Blue cross blue shield (*We are only contracted with some BCBS plans~please call your representative to determine if we are contracted with your plan)
  • Cigna PPO & PPO Advantage
  • Delta dental (*Premier Plan only)
  • Guardian
  • MetLife PDP
  • Tricare

Our payment methods are as follows:

  • Cash
  • Check
  • Visa
  • Mastercard
  • American express
  • Discover
  • CareCredit (CareCredit is a credit card for dental services that offers 12 months of interest-free financing. You may learn more about this @ carecredit.com.)