Forms

Special Notice About Insurance

We accept all insurances such as Metlife, Guardian, Sunlife, Humana etc.; although any HMO, EPO and Medicaid plans do not offer any benefits.  Some plans have limited coverage such as Delta PPO, Cigna Advantage and the Anthem BC/BS Prime plan. You will make the most use of insurance companies that we are in network with, but most of the out of network insurances still offer great benefits comparable with in network coverage. We are in network with:

• Delta Premier
• Cigna Total
• Aetna
• United Health Care
• Anthem BC/BS

Each plan is different and we would be happy to check the specifics of your plan before your visit.

Online fillable forms

Forms

Patient Information Form

Medical History Form

Authorization to Release Dental Records Form

Office Policies Form

Printable forms

Patient Information Form

Dental Records Release Form

Medical History Form

Office Policies