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Online Patient Intake Form

Patient Forms

Help us get to know your child!

Please take a minute to print and fill out the patient information forms before your first appointment:

We look forward to meeting you and your child at the first appointment.

Our services

We accept Medicaid and most forms of insurance. We will process insurance claims for you and explain your portion of the cost. We accept emergencies and walk-ins.

Insurance

Your treatment plan will include a breakdown of all applicable fees, and we will inform you of all costs before treatment is administered. Charges are payable at the time of treatment.

Pediatric Dentist's

A child's first visit to the dentist should be enjoyable. Children are not born with a natural fear of the dentist, but they can fear the unknown.

Pediatric Dental Emergencies

If you face a dental emergency, give us a call immediately. If you need urgent treatment after hours, you can call our emergency number.

Sedation Dentistry

There are times when our dentists recommend some type of sedation, based on the severity or length of procedure.

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