If you are a new patient to our office, the attached files contains our new patient forms that you need to fill out.  Printing them, filling them out, and bringing them with you will allow us to attend to your dental needs more quickly than completing them in our office upon your arrival.  Thank you and please call our office if you have any questions at all.

Please bring to first appointment:

Patient Information Form
Financial/Cancelation Policy Form
Privacy Practices Acknowledgement

Keep for your Records:

Notice of Privacy Practices

For your convenience:

Records Transfer Request

This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

Payment Options

For your convenience, we accept cash, personal checks, money orders and major credit cards. Payment is expected at the time services are performed. When more extensive dental care is necessary, financial arrangements can be made with our office.

Financing Options

We offer different options for financing your dental treatment.   After you and Dr. Film have finalized your treatment plan, our office manager will determine your financing options.  We partner with CareCredit, www.carecredit.com, to offer 12 month, interest-free financing to those patients who qualify.  We also offer in-office, automatic payment plans.  More details are available by contacting our office manager.

Insurance

As a service to our patients, our practice accepts most dental insurance programs, including non-managed care, indemnity (traditional) and PPO out-of-network.  We are not, however, an in-network or participating provider of any insurance company.  Our office manager will prepare all the necessary forms for your dental benefits. However, we remind you that your specific policy is an agreement between you and your insurance company. Please keep in mind that you are responsible for your total obligation should your insurance benefits result in less coverage than anticipated. Our staff will gladly submit a pre-treatment estimate to your insurance company so that you will know what your benefits will be.

The fees charged for services rendered to those who are insured are the same fees charged to all our patients for similar services. Your policy may base its allowances on a fixed fee schedule, which may or may not coincide with our fees. You should be aware that different insurance companies and plans vary greatly in the types of coverage available. Also, some companies take care of claims promptly while others delay payment for several months.