Patient Forms
To save time, you can print out the forms below and fill them in before visiting our office.

1)  New Patient Form

Aetna
Ameritas
Assurrant
Blue Cross
Blue Shield
Cigna
Connection Dental
Delta Dental Premier PPO, DPO
Delta Dental Motion Picture
Delta USA
Dental Benefit Provider
GEHA Dental
Guardian
Health Net
Humana
Metlife
United Health Care

If you have a dental PPO plan that is not in the list above, please call us. We will verify your insurance to see if we are an in-network provider.

Payments
We accept PPO insurance (see left), cash, & credit cards.

For our patients’ convenience we have arranged a payment plan through a third party, Care Credit, that helps our patients receive their treatment in a timely manner, at 0% interest.