Patient Information

Financial Information

Our doctors and staff understand that accurate financial information is important for our patients. To expedite the treatment process, when indicated, our staff will contact your insurance company for an estimate of your benefits. We will make every effort to make sure that this information is as accurate as possible. When necessary or requested by our patients we can obtain a written statement pre-authorizing the recommended treatment.  In addition, as a courtesy to our patients, we offer several different payment plan options. Each option will be individualized based on your treatment needs and will be discussed with you during the initial consultation appointment. We highly encourage our patients to contact our office staff regarding any financial questions, concerns, or suggestions.

Registration Forms

Please download and complete the forms titled “Patient Registration”, “HIPPA Acknowledgement of Privacy Policy”, and “Financial Agreement”.  Please bring these forms with you to your first appointment. The form titled “HIPPA Privacy Policy” is for your records.

Patient Registration .pdf HIPAA Privacy Policy.pdf HIPAA Acknowledgement of Privacy Policy.pdf Financial Agreement.pdf Consent To Share.pdf

Lending Club Patient Solutions

Our practice is pleased to present flexible payment plans through Lending Club Patient Solutions. Lending Club Patient Solutions offers:

  • Patient-friendly, True No-Interest Plans with NO retroactive interest for 6, 12, or 18 months
  • No upfront payments
  • No prepayment penalty

It’s easy to calculate your potential monthly payments. Simply complete a short application which displays fixed rates and monthly payments available for Extended Plans, all without impacting your credit score.

For more information, simply ask a team member or visit






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