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Patient Resources
Fast. Simple. Secure.

Patient Forms

You can fill out your new patient paperwork via our secure portal prior to your appointment. As a HIPAA compliant practice, we always take extreme precaution that all patient information is securely transmitted and added to our systems.

Make a Payment

Make a quick and easy payment online. All you need is a payment method handy.(Click "Make a Payment", enter full name/date of birth, and follow the steps)

Patient Portal Login

Log-in to your patient portal access your patient information, treatment plan, appointments, etc. If you need login information, it was emailed to you with subject line "Patient Portal Invitation." If you can not access it, then please email us and we can help.

No Insurance? No problem.

Our office offers discount membership plan for patients who do not have insurance. Free cleanings and free exams are some of the key features of this plan.

Patient Referral Form
( Must be filled out by Referring Doctor )

We welcome referrals from doctors as we provide a comprehensive dental services in one office. To submit a patient referral, please submit our patient referral form

Sedation consent forms

Our office offers anxiety-free sedation for patients who fear dental treatments. We require Sedation consent forms to be submitted prior to your sedation appointment.

Consent for unaccompanied minors

We recognize that parents may drop a minor patient off or the minor patient may drive themselves to their dental appointment. In order for us to be compliant with State laws and Dental Board regulations, we do require a signed consent form that permits our providers to treat an unaccompanied minor (under 18).

Responsibility of financial payment

Any or all treatment whereby a patient (above 18) can not pay for treatment and requires someone else to pay for the patient's treatment, then the patient can assign another person the responsibility party for all financial obligations for treatment

Specific Dental Power of Attorney

Depending on patient situation, we may require the patient to appoint an agent to make any and all dental care decisions for the patient. Any agent appointee can be revoked in writing to our office via email or fax.

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