New Patients

BEFORE YOUR FIRST VISIT
Download, print, and complete the necessary forms BEFORE your first visit.

FIRST VISIT
We would like to welcome you to our dental office. Our goal is to make you a patient for life.

You will be greeted by our Patient Care Coordinator who will take you on an office tour to meet our staff and see our facilities. Next, one of our dental assistants will accompany you to the treatment room where she and Dr. De Bry will:

    • Discuss any concerns you have, or oral problems you've been experiencing

    • Review your medical and dental history

    • Clarifying your concerns, wants and expectations and/or problems

    • Take a series of diagnostic X-rays to provide a detailed radiographic view of your teeth and bone condition.

    • Perform an oral cancer screening: the insides of your cheek, your gums, the sides, top and bottom of your tongue, the roof and back of your mouth will be examined for normal and abnormal sores or lesions.

    • Perform a hard tissue exam for any cavities using: Diagnodent: a simple laser diode tool used to inspect your teeth as a means of detecting cavities so your exam can be fast and easy

    • Perform a complete periodontal exam: the gums and bone that surround your teeth will be evaluated for signs of hidden gum disease.

    • Comprehensive dental evaluation is recorded in your tooth chart showing your existing and needed dental     work

    • Take a tour of your mouth with an intra-oral camera: a miniature video camera at high magnification

    • Treatment plan which is a written explanation of the complete findings about your dental health. We encourage you to ask questions because your input into your treatment plan is very important.

    • Verbal and written educational materials are provided based on your dental needs.

    • "Cleaning” of your teeth may be done depending on the results from this exam. Dental cleanings are done by our qualified dental hygienists.

After your examination, Dr. De Bry will review all findings, discuss your treatment recommendations and sequence, give you a customized written report (Treatment Plan) and answer all questions to your satisfaction and understanding. This will take place at your first visit or at the no fee consultation, depending on the complexity of the required treatment.

Our Financial Coordinator will met privately with you to cover your treatment and financial options and our fees.

FINANCIAL POLICY
Thank you for choosing us for your dental needs. We are committed to providing you excellent care and payment of your bill is part of successful treatment. Our financial policy is based on an open and honest discussion of our fees. You will be asked to read and sign a copy of this policy prior to treatment.

PAYMENT IN FULL IS DUE AT THE TIME OF SERVICE
    • We offer several options of payment for the treatment we provide.
    • We accept cash, checks, Visa and MasterCard.
    • We offer interest-free financing through CareCredit.

FINANCIAL ARRANGEMENTS MUST BE MADE PRIOR TO TREATMENT
• Usual and Customary Rates: We are committed to providing excellent dental treatment to all of our patients. Our fees reflect our commitment to the quality of service our patients deserve and are considered usual and customary for the area, regardless of any insurance company’s determination.

INSURANCE
As a service to our patients, we will bill your insurance company if you provide us with your insurance information. Your insurance policy is a contract between you and your insurance company; as a medical provider, we are not party to that agreement. Insurance policies vary and services provided may not be covered. Our office is committed to helping our patients maximize their benefits, but you are responsible for any fees or portion of fees that your insurance does not pay. We are always available to answer your questions.

MINORS
Payment for services of the treatment of minors can be made by cash, check or credit card, and is the responsibility of the adult accompanying that minor.

MISSED APPOINTMENTS
Be advised that the policy of this office is to charge for missed appointments unless they are cancelled 24 hours in advance. Once an appointment has been made, please remember this time has been reserved specifically for you. This better enables us to serve your needs. ($150 charge)

COLLECTION FEES
Fees incurred to collect payment will be billed to and payable by the patient.

FINANCIAL CONSENT
The patient (guardian) agrees to be fully responsible for total payment of treatments performed in this office.

MISSED CHARGE AT TIME OF SERVICE
We reserve the right to add any missed charges to the account.