Welcome to our office! Thank you for taking this very important step towards achieving excellent dental and overall health. We promise you a new and refreshing experience, transparent communication, and a personalized approach to healthcare.

• We will provide explanations before you ask, but you will have the opportunity to question anything and everything that is not clear to you. We enjoy questions, so please ask.
• As a new patient for biological dentistry, your first appointment will include a detailed consultation, necessary x-rays, examination, diagnosis, and treatment planning. This will be about 90-120 minutes long.
• Our office is a “one patient at a time” office. We devote our time solely to you. Please take only those appointments you can keep. Cancellations or missed appointments without at least a 48-hour notice prevent other patients from receiving care and are subject to fees. Please see the policy on the next page.
• Please keep cell phones on silent. They are distracting to your doctor and others.
• We share your concern about your children and loved ones. Rest assured that we will treat them with all the care you expect. However, parents, relatives, and friends should wait in the reception room during treatment sessions to ensure your child’s best behavior and treatment outcome.
• Refunds can only be made if you have a credit balance, even if other payments are anticipated (e.g., insurance).
• Payment plans (no-interest or low-interest) are available for your convenience upon approval of credit.
• Checks are not accepted without an established history in our office. Checks not honored by your bank (“bounced”) will result in a minimum $35.00 service charge. We also reserve the right to charge the maximum amount allowed by law.
• Dental insurance does not eliminate your financial responsibility for treatment rendered. As part of our service, we will estimate your insurance benefits and often extend credit to you in anticipations of insurance payments. But initially we can only provide a rough estimate. What your insurance does not cover or pay for, you must pay. For example, if your insurance company provides us with your coverage eligibility dates, but later, at the time of billing, claims you were not eligible due to policy termination, employment changes, cancellation, or any other reason including error, even if you were not aware of the change or error, you are still responsible for all charges. We will do our best to help you with your insurance, but your insurance coverage is your responsibility regardless of what information, accurate or not, was provided to us by your insurance co.
• Payment is required in advance. We do not bill. However, in the unlikely event of an ending balance, delinquent accounts are charged a 5.00% late fee per month (minimum $45.00 per month). Extended delinquencies beyond 90 days will affect your credit rating and result in legal action.
• In case of default in payment of any sums of money for services rendered, patient (legal responsible party) hereby agrees to pay a reasonable attorney fee, late fees, and all court costs incurred by the holder in such action. Said party hereby waives, to the fullest extent permitted by law, diligence, demand, protest, notice of protest, and the benefit of any statute of limitation.

Please sign the Patient Information form to acknowledge and agree to these policies.