For Our Patients

To make your dental care experience as easy and convenient as possible, we’ve put our patient forms online and provided information about payments and insurance. This way, you’ll have all of the information you need when you visit our office. Of course, we’re always available to answer questions and provide whatever you may need. Just ask!

Patient Forms

Our new patient forms are available as Adobe Acrobat files. For your convenience, we recommend printing and completing these forms at home.

Please remember to bring your completed forms to your first appointment. If you have any problem getting these files to print properly, please call our office and we’ll gladly send or fax them to you.

Patient Forms

• Dental/Medical History Form
• Registration History
• Acknowledgment & Consent Form
• Financial Policy
• Medical History Update Form
• Change of Information Form

Download Adobe Acrobat Reader Now

Payment & Insurance Information

Review the information below to learn more about dental insurance. To learn about third-party financing, visit the CareCredit website.

About Dental Insurance

• Many patients think that their dental plan pays 80 to 100% of their dental costs. We’ve found that many plans actually cover about 40 to 50% of an average fee.
• Insurance coverage is a matter between your employer and the insurance company. We are not involved with any insurance company; therefore, your benefits are not determined by our office.
• Please read your policy so that you are aware of any limitation of benefits. Some routine services and preventive procedures are not covered by insurance. We’ll cooperate in any way that we can to help you obtain the maximum benefit from your insurance coverage.
• Our front-office team will complete your insurance forms and electronically submit them to your insurance company.
• Insurance claims are submitted after each visit. Please remember that patients are responsible for any costs not covered by insurance.
• Looking for a new dental insurance carrier? Ask us about Direct Reimbursement plans that eliminate the “middle man” and cut employers’ costs without sacrificing quality.

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Call one of our conveniently located offices today to schedule your appointment with one of our dentists. From our Arlington, Southlake, and Fort Worth offices, we provide personalized, full-service dental care to give patients beautiful smiles and whole-mouth health.