Patient Information
PATIENT RESPONSIBILITYPERTINENCEREFERRALREGISTRATION FORMSREQUESTING SOCIAL SECURITY NUMBERCANCELLATION POLICYTARDINESSPAYMENT POLICYINDEPENDENT FINANCINGPREPAYMENT REQUIREMENT FOR DENTAL LAB WORKDENTAL INSURANCEINSURANCE PAYS SUBSCRIBEREMERGENCY APPOINTMENTINITIAL APPOINTMENT (NON-EMERGENCY)TREATMENT PLANAPPOINTMENT ORDERAPPOINTMENT CONFIRMATIONSCHEDULE CHANGESAPPOINTMENTS FOR FAMILIESREFUSAL OF TREATMENTRECORD TRANSFER REQUESTQUESTIONSDISCLAIMERHIPAA NOTICE OF PRIVACY PRACTICESSCHEDULE CHANGES
If there is an opening in the schedule, we will attempt to fill it by moving scheduled appointments forward. If you are contacted regarding moving forward an appointment(s), you are under no obligation to accept. If a new appointment date and/or time is accepted, the previous appointment date and/or time is cancelled, unless otherwise specified. If a new appointment date and/or time is accepted, 24 business hour advance notice of inability to attend the new appointment, as described in the cancellation policy, will apply.