Office Policies

Dental Appointments

Our goal is to provide quality care to all of our patients. When an appointment is scheduled, a reserved block of Doctor’s time has been provided for you and/or your family. We understand your time is valuable and so are your commitments. Please schedule accordingly. A reservation fee WILL be collected at the time of scheduling.

We reserve the right to charge a $50.00 fee per HR for any missed or rescheduled dental appointments that have not been cancelled/rescheduled 48 hours prior to the scheduled time.

We reserve the right to charge a $100.00 fee per HR for any Specialty Appointments missed or rescheduled dental appointments that have not been cancelled or rescheduled 72 hours prior to the scheduled time.

Due to high demand of our Saturday appointments, limited spacing is available and a 72 hour notice is required for any cancelled or rescheduled appointments. A $100.00 fee per HR will be applied. Once a Saturday appointment is missed, another Saturday will not be appointed.

Confirmation/Late Appointments

All patients that arrive more than 15 minutes late for a scheduled appointment may be rescheduled. This does not apply if prior arrangements have been made. ALL appointments must be confirmed. Failure to do so will result in the appointment being CANCELLED.

Financial Responsibility

Your signature on this form acknowledges that you, the patient, parent, or legal guardian, agree to bear full financial responsibility for all services provided if:

1. You are determined not to be eligible for insurance coverage.
2. The services are not a covered benefit under your plan.
3. There is a patient portion determined by your insurance plan that is payable at the time of scheduling your reserved appointment.
4. Unpaid past due balances may be subject to interest charges.
5. We DO NOT guarantee what insurance will cover. We can only provide an estimate.

Please keep in mind, any financial estimates presented to you for dental treatment, is only an ESTIMATE of what your insurance company will pay. We cannot guarantee what insurance will pay. **Financing options are available**

Co-Payments/Reservation Fee

We will collect either the entire copayment or a portion to reserve an appointment for treatment with the dentist or hygienist. If the appointment is missed or failed to met the office policy, the cancellation fee WILL be deducted from the Reservation Fee.

Returned Checks

A fee of $35.00 will apply for any checks returned to us for any reason. Future services will require payment by cash or credit card.