PATIENT INFO
Patient Information
Patient Forms
We know your time is valuable – you want to finish your dental appointment and get back to your busy life as quickly as possible. That’s why we provide several patient forms online.
New patient registration information and a detailed health history are very important to your dental care. If you are a new Columbia Pike Family Dentistry patient, please complete these forms at your convenience. Feel free to call our office if you have any questions or need assistance with the forms.
Payment Options and Insurance
Making sure you receive the dental care you need and desire is our priority.
We offer these convenient payment options:
- Cash
- Credit card (Visa, MasterCard, American Express, Discover)
- Financing through CareCredit
- Click Here to Pay Through CareCredit.
We also accept many dental insurance plans.
We will be happy to verify acceptance of your plan, fill out claim forms, and assist in obtaining an estimate of coverage. Please be aware, however, that insurance is a contract between the patient and the insurance carrier (NOT the dentist and the insurance company). Any non-covered services or non-covered portions are the responsibility of the patient. Payment is required at the time the service is provided or when the insurance payment amount is determined.
CareCredit
CareCredit is available to help you pay for treatments and procedures your insurance does not cover. CareCredit offers No Interest* financing or low minimum monthly payment options so you can get what you want, when you want it. You can even use CareCredit for your family and favorite pet.
With three simple steps, including an instant approval process, it’s easy to apply for CareCredit. After you’re approved, you’re free to use CareCredit for the services you choose including LASIK, veterinary, dentistry, cosmetic, hearing aids and more.
CareCredit is endorsed by some of the most credible organizations specific to each healthcare profession we support. And, CareCredit is a Synchrony Bank company, so you know you can count on them. For over 20 years, CareCredit has been helping over five million cardholders get the healthcare treatments they want and need.
CareCredit is available to help you pay for treatments and procedures your insurance does not cover. CareCredit offers No Interest* financing or low minimum monthly payment options so you can get what you want, when you want it. You can even use CareCredit for your family and favorite pet.
With three simple steps, including an instant approval process, it’s easy to apply for CareCredit. After you’re approved, you’re free to use CareCredit for the services you choose including LASIK, veterinary, dentistry, cosmetic, hearing aids and more.
CareCredit is endorsed by some of the most credible organizations specific to each healthcare profession we support. And, CareCredit is a Synchrony Bank company, so you know you can count on them. For over 20 years, CareCredit has been helping over five million cardholders get the healthcare treatments they want and need.
