Office Policies

Patient Dental History Form
Medical History Form
Insurance Information Form
Office Policy Form

Office Policies

  • Insurance

    As a service to you, our office will submit an insurance claim for payment to your dental insurance company to reimburse you. Subscriber information is required to obtain payment from your insurance company. Confirmation of coverage and eligibility may be required for service. Our office reserves the right to decide whether we will transact with, submit claims to, or process claims to any assigned dental insurance, or to a dental insurance plan with which we are not a provider. A dental insurance plan is between a policy holder and the insurance company. For this reason, we are often unable to communicate directly with your plan provider. It is the account holder’s responsibility to understand the coverage and benefits of the patient’s dental plan.

    Payments

    We Accept Mastercard, Visa, Debit, Cheque and cash to best serve you. Unless otherwise arranged, payment is expected upon completion of treatment. Multi-visit service appointments require portioned amounts to help cover any work performed, lab fees, expenses, supplies and materials used during treatment. Any remaining portion is expected at the completion visit.

    Missed Appointments

    Our office requires a minimum of 2 business days to reschedule or cancel an appointment. Please be aware that this time has been specifically reserved for you and a fee may be incurred if we receive insufficient notice. The fee for a missed appointment with the dentist or hygienist is $100.00 per hour. Please be aware that we review each situation individually the fee may be waived if circumstances dictate. We do our best to contact patients, usually by email, to remind them of upcoming appointments but respectfully ask that you create a reminder of your own and confirm your schedule.

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Patient Dental History Form
Medical History Form
Insurance Information Form
Office Policy Form