Please print the necessary forms below and bring them with you to your first appointment.
(1110, 0274, 0150)
Includes cleaning, exam, and x-rays for uninsured new patients
*For Non-Insured New Patients
(0140, 0220)
Regular value of $116
(0150, 1120, 0272, 1208)
Regular value of $214 includes necessary x-rays & fluoride treatment
*New Patients Only