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New Patient Form
Health History
Notice of Privacy Practices-HIPAA
Notice of Privacy Practices – Acknowledgement
Health Care Release Authorization
Informed Consent Declaration for Minors
Notice of Exclusions from Medicare Benefits
Medicare Private Contract
Consent for Dental Implants
Consent for Oral Surgery
Consent for Root Canal Treatment
New Patient Checklist
New Patient Form
Health History
Notice of Privacy Practices – HIPAA
Notice of Privacy Practices – Acknowledgement
Health Care Release Authorization
PRACTICE PHILOSOPHY:
Dentistry is a very personal health service; therefore, every effort is taken to ensure that each visit is an opportunity for you to share in reaching your oral health goals. Our personal touch begins with your first visit, at which time we will listen to your individual needs and desires as well as review your medical and dental history. The clinical exam may include blood pressure screening, digital X-rays (low radiation exposure), photographs, cancer screening, diagnostic models, dental (teeth) and periodontal (gums) measurements.
We are a comprehensive dental practice that incorporates a wide range of diagnostic tools and skills in an effort to provide you with exceptional preventative, restorative and aesthetic therapy. Keeping abreast and incorporating the technological and innovative advancements within dentistry is a key component to providing our patients with unparalleled benefits for their oral health care.
RECARE:
We believe regular preventative care is in our patients’ best long-term interests. During your preventative care visit, we will assist you in evaluating your oral hygiene regimen, periodontal status and teeth. Your next preventative care visit will then be scheduled. For your convenience, we will send you a reminder recare card prior to your next visit. In addition, to help you manage your busy schedule, we utilize appointment reminder calls and emails. If at any time, you wish your method of communication to be adjusted, please inform one of our friendly team members.
INFECTION CONTROL:
Your health and well being are important to us. Every necessary step is taken to safeguard your health during any visit to our office. In our ongoing efforts to provide the safest of environments for our patients, we use the most up to date sterilization techniques and procedures available as well as training annually to ensure these protocols are met.
We strictly meet or exceed all recommended infection control procedures by wearing gloves, masks, protective eyewear and lab pants and jackets. Every member of our team attends, on an annual basis, WISHA/OSHA training. In addition, we have a consultant who keeps us abreast of any current changes that occur throughout the year that we, and you, need to aware of and informed. We also follow rigorous cleaning, disinfecting and sterilization protocols.
If you have any questions regarding our Infection Control Protocols or procedures, please feel free to ask. We are more than happy to provide that important information to you. Click here to learn more about our sterilization policies.
ABOUT OUR FEES:
Our fees are based on our industry knowledge, expertise, education and high level of service. You will find them consistent with the exceptional quality, service and expertise of oral health care you receive.
In addition, we offer a full range of Financial Arrangements to make quality care affordable and convenient.
INSURANCE:
Your care is a relationship with us and we value this relationship. With the constant changing of insurance benefits, it is easy to become lost in the paperwork and policies. We are here to help you understand and maximize the benefits of your dental insurance. Dental insurance is a contract between you (the patient), your employer and the insurance companies. Dental insurance can be viewed as pre-paid dental. Although we have no control over the terms and conditions of your dental insurance, we will gladly assist you in maximizing your insurance benefits, file the necessary forms for you and assist you in any way we can. We assure you our recommendations are based on your care, not insurance coverage.
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