New Patient Forms

Welcome!

We are looking forward to meeting you in person! If you have already set up a reservation to see us for the first time, or of you are planning to do so, you can save time on your welcome visit by reviewing and completing the following welcome packet! Please call with any questions you may have and we will do our best to answer them for you! If you have family or friends also due for an oral health visit please let them know about us so they can also be a part of our dental family!


1) Welcome Letter

New Patient Welcome Letter.docx


2) Health History

New Patient Health History (1).pdf


3) Level of Care

Level of Care KD (1).docx


4) Financial Agreement

NP Financial Commitment Agreement.docx


5) Photo Release

Photo Release (1).docx


6) HIPAA Form

Updated HIPAA.docx                                                                                    


7) Smile Evaluation

Smile Evaluation.docx


Insurances we offer

We file most insurance plans!   We are also in-network providers for Delta Dental Premier.

Insurance can often be confusing and we understand! Please Call our office with any questions you may have and our experienced staff is happy to answer them!

Payment Arrangements

We work closely with you to help fit your dental goals into your life. We offer many options as well as payment plans through Care Credit. We will go over these with you during your visit to help you make the best choice.

Emergency Services 

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Have an emergency? Dr. Kelly and his team are often available for Emergency Services. Call our office 24/7 for more information.