Dental Policy


    A full 2 business days notice is required to change your scheduled appointment or a fee will be charged according to the amount of time booked for your reserved appointment.


    It is your responsibility to remember your appointment. Our office will be more than happy to give you a courtesy reminder for any booked appointments.


    As a courtesy, our office will receive payment from your insurance company. Contact your insurance company or your plan benenfits department if you need information regarding your policy. It is your responsibility as our patient to provide us with correct insurance information.


    Please note that your insurance company may not give our office informaiton regarding your contract policies, this is under the Policyholder's Privacy Act. Coposite (white) filings on permanent molars are sometimes not covered under your plan contract. Your insurance plan will covcer the equivalency of an amalgam (silver) filling. The cost difference for this type of restoration may vary from $40.00 to $160.00 per tooth. I authorize my dental office to send my dental claims to my insurance company electronically.


    Dental treatment amy not be covered or may exceed your plan benefits. You understand that you are financially responsible to the dentist for the entire treatment rendered.

  • Payment for any treatment not covered needs to be paid when services rendered,unless payment plan has been previously arranged by you and the dentist.

  • I have read and fully understand the above office policy regarding my dental insurance and my patient responsbility.