Forms

Forms 2017-05-30T10:57:02+00:00

Your First Appointment

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 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 of 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 New Patient Registration Forms on the right and fill them out completely before coming for your appointment.

First Visit:

At the first visit you can expect a comprehensive examination and x-rays. Hygiene treatment with the doctor or hygienist will be provided if scheduling allows. If the reason for 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.

Note: X-rays

If you have had a full set of x-rays taken within the past year please have them transferred to us prior to your visit in order to avoid a repeat!

New Patient Forms

Forms – All forms are in portable document format and require Adobe® Acrobat Reader™ for viewing. Click here to download Adobe® Acrobat Reader™.

Downloadable Forms:

  1. Patient Information
  2. Health History
  3. Office Policy