Patient Info

Financial Information

Patient Forms

Health History Form

Consent Form

Referral Form

INITIAL VISIT

Please assist us at the time of your first visit by providing the following information.

– A referral slip and x-rays taken from your referring dentist.
– Completing your personal and health history form, including a list of any medications you are currently taking.
– If you have dental insurance, please bring your insurance card.

Your first visit will consist of a consultation where we review your medical history, perform diagnostic testing, acquire imaging, and ultimately come to a diagnosis. This consultation appointment is how we determine what your endodontic needs are. If we are evaluating a previously treated root canal, we will most likely obtain a 3D Cone Beam image of the tooth. Several other important items will be determined at this consultation visit such as, but not limited to:

  • Does your treatment require the use of nitrous, sedative medication, or IV sedation?
  • What is the complexity of your treatment and how many visits will be required?
  • Does your case require discussion with your referring dentist about the future restorative plans?
  • Do you require antibiotics prior to treatment?
  • Do we need to contact your physician/alter any current medications prior to treatment?
  • Are there existing dental issues that can affect treatment, such crowns, posts, cracked teeth, and previous root canal treatments?

Once we have determined what your needs are we will be able to appropriately schedule your treatment appointment.  Very often we are able to do root canal treatment at the same appointment as the consultation if the situation is urgent and you are in pain.

FINANCIAL

We offer our patients several payment options.

We work with all PPO insurances and are preferred providers for Cigna, Delta (Premier and PPO), Anthem (Grid+), and United Concordia.   We accept care credit where you can apply here.

We submit claims electronically, expediting the processing of all claims. Most insurance companies will respond within four to six weeks. Please allow our office that time for the full process of your claim. Please note that all benefits quoted are not a guarantee of payment by the insurance company.

Basic

Details pertaining to your membership plan(s) will go here. This can be a blurb or a list of bullet points, pricing, etc.

Premium

Details pertaining to your membership plan(s) will go here. This can be a blurb or a list of bullet points, pricing, etc.