New Patient Paperwork

Please click the link below.

Each new patient to our office is asked to complete a few forms regarding your personal information and dental health history.  If desired, you may click the link below and fill out the forms before your first visit or you may complete them in our waiting room.

Insurance Information

Thank you for selecting us to care for your dental needs!  Our office files insurance for most providers and serves as preferred providers for the following companies:     

  • Aetna PPO Insurance  
  • Aetna Discount Plan
  • Ameritas  
  • Assurant  
  • BCBS (Choice, Dental Blue, FEP, Highmark,Traditional, Illinois, South Carolina)  
  • Cigna (Total Cigna DPPO, Cigna DPPO, PPO)  
  • Coventry Healthcare (Patient may call it Dental Guard)  
  • Dearborn  
  • Delta Dental PPO  
  • Delta Premier  
  • Delta Dental Tricare 
  • Dental Care U.S. 
  • Dental Network of America  
  • Dentegra  
  • First Priority Life and First Priority Health
  • Guardian  
  • HealthChoice  
  • Highmark Companies
  • Metlife  
  • Physician's Mutual
  • Principal  
  • Reliance and Reliance Standard
  • United Concordia  
  • United Concordia-Tricare
  • United Healthcare (some groups)

Insurance Not Based on Network

  • UMR (Connection Dental): CREC
  • NTCA