When you call to make a new patient appointment you will need to furnish us with the required information to get insurance verification and eligibility. Proof of identification and dental insurance card are required at initial visit. Without this we will be unable to bill your insurance and you will be responsible for all charges at the time of the visit. - Name, Social Security #, date of birth, and employer of the insured - The name and date og birth of the patient, if different than the insured - Insured’s employer and Group id, if available Accepted Insurance Plans 1. Metlife PDP 2. Cigna/ Connecticut General 3. Delta Dental plan Premier 4. Fortis 5. Guardian PPO or Dental Guard Preferred 6. As well as many others, please call for details about your specific plan Before You Arrive Please print the registration forms (located at the bottom of this page) and fill them out completely before coming for your appointment. At the first visit you can expect a comprehensive examination and xrays. Hygiene treatment with the doctor or hygienist will be rpovided if scheduling allows. If the reason of your first visit is outside the realm of routine follow up and maintenance please inform the receptionist so that your appt will be scheduled appropriately. Xrays- If you have had a full set of xrays taken within the past year please have them transferred to us prior to your visit in order to avoid a repeat. Forms- All forms are in portable document format and require Adobe® Acrobat Reader™ for viewing. Click here to download Adobe® Acrobat Reader™. Download the forms individually:
Patient Information
Health History
Office Policy
Oral Cancer Screening Consent Download all of the forms together:
Patient_Forms |