Please print out the forms below and fill out to bring in to your first appointment. Thank you and we are looking forward to seeing you soon.
Need Adobe Acrobat Reader?
If you do not have a copy of Acrobat Reader you can get one for free by clicking on the Acrobat® Reader icon. This will take you to Adobe’s website and enable you to download the Acrobat program to your computer.
We offer convenient payment and financing options to help you afford the care you need. Dental treatment can be an exceptional investment, and if the financial consideration is an obstacle, we partner with financing partners to provide you with convenient payment options.
If you have more questions or would like more information about our financial policy, call our financial coordinator, Judy, at (215) 885-0555.
CareCredit® for Dental Procedures
We’re pleased to offer our patients CareCredit®, North America’s leader in patient payment plans. CareCredit® lets you begin your treatment immediately – then pay for it over time with monthly payments that fit easily into your monthly budget.
Your healthcare credit card
CareCredit® is the credit card exclusively for healthcare services. With no up-front costs and no pre-payment penalties, CareCredit® lets you pay over time and frees up cash and credit cards for the other things you want or need. CareCredit® offers monthly payment plans for healthcare procedures not commonly covered by insurance, including dental treatments. Plus, you can use your card again and again to pay for additional treatment for yourself or family members in any CareCredit® practice.
- Enjoy minimum monthly payments
- Pay no up-front costs or pre-payment penalties
Learn more by visiting carecredit.com or contacting our office. Ready to apply? Apply online for your CareCredit® card today. You’ll be smiling bright in no time!
Our insurance coordinator, Beth, is happy to assist with any of your dental insurance needs. We make every effort to provide you with the finest dental care and the most convenient financial options. To accomplish this goal, we work hand in hand with you to maximize your insurance reimbursement for covered procedures. Please be sure to bring any insurance cards and information with you to your appointment. As a courtesy to our patients we will submit all claims electronically the same day as your visit. Beth is always available to answer any questions or concerns you may have. For assistance call our office at (215) 885-0555.