First Visit
Please bring the following info to your appointment
- Referral Slip
- Images (X-rays) if any and date taken
- Driver’s License or State ID
- Dental Insurance Card(s)
- Policy Holder Information
- We will need the policy holder’s name, birthday, SS# or dental plan ID#, and employer
Dental Plan
We will only provide you with an estimated copay for consult and treatment. Copayments will vary due to the type of dental plan you are currently enrolled in.
Estimated Copayments:
- Consultation $150
- Consultation and Treatment $150 – $1,800
IMPORTANT
Pain medication
If you are having dental pain and are being seen on an emergency basis, please WITHHOLD from taking any pain medications before your appointment.
If the patient is a minor
- A parent or guardian must accompany the minor (18 years and younger) to all appointments.
- If accompanied by others, a parent or guardian will need to provide the office with:
- The name of the individual
- A signed consent letter
- A copy of your valid Driver’s License
- A HIPPA Form completed prior to the appointment
- A parent or guardian will need to be available by phone
If you are pregnant
- Please NOTIFY us
- We need the OBGYN name and contact information
- We require an OBGYN treatment authorization letter prior to your appointment. Without an authorization letter, your appointment will be rescheduled.
If you are required to pre-medicate
- Take 1 hour before your appointment, as instructed to do so by your healthcare provider
List of medications (this list should include)
- Prescription medications with dosage
- Reason for taking medication
- Over the counter medications, vitamins, and or herbal products
- Your allergies and what symptoms you have