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Patient Forms

• Patient Registration Form
  

Appointments
We know you have many choices when choosing a Dentist in Springfield , OH so we have made requesting an appointment a simple process via our Web site. If, for any reason you cannot keep a scheduled appointment, or will be delayed, please call us as soon as possible.

Insurance and Billing
We accept most traditional insurance plans, contact our office to verify acceptance of your plan. We do not participate in Health Management Organizations; however, we will be happy to file your insurance claims for you. We accept checks, cash or credit cards. We also offer a flexible payment plan. Please see our Financial Coordinator for details. We are happy to file insurance for your reimbursement as long as you are free to choose your own dentist.

Accepted Insurance Carriers
We are providers of all benefit plans but participate with only some. Please call to confirm your coverage.

Billing Procedures / Payment Plans
Payment is expected at the time of service but unless prior arrangements are made. Payment plan options through CareCredit and we accept Visa, Mastercard and Discover.

Appointment Scheduling Details
Initial appointments for new patients usually include a comprehensive exam and X-rays with discussion of any treatment planned.