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New Patient Registration Forms:
The New Patient forms are in PDF format, which can be read using Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader, get a free copy by clicking on the link below.
When you have Acrobat Reader, click on the links below to download the New Patient forms. Then print the forms, fill them out, and bring them with you on your first visit.
Medical
History Form (pdf file)
Insurance
Information Form (pdf file)
Insurance:
Dental insurance is intended to cover some, but not all of the cost of your dental care. Most plans include coinsurance provisions, a deductible, and certain other expenses which must be paid by the patient at the time of services. Reimbursement amounts are not, and never have been, a guideline for quality care.
We can file most insurance
claims for you. Please bring your insurance plan information with you
on your first visit. We will work with you to ensure that you receive
the maximum benefits to which you are entitled.
Payment:
Payment is expected at time of service. If you have insurance, you will be expected to make an estimated payment for that portion not covered by your insurance plan. For that portion of costs not covered by insurance, we offer several payment options:
- Cash or Personal Check
- Credit Card - We accept MasterCard, Visa and Discover.
- Capital One Healthcare Finance is a convenient, no initial payment, low monthly payment plan for dental treatments of $300 to $25,000. You can apply in our office or apply online.
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If you have any questions
about your insurance plan or payment options, please call Our staff
at (620) 663-5595
or
e-mail us at sweetdds@swbell.net.
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Us |
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© Copyright 2003- Dental WebSmith, Inc. and Robert L. Sweet, D.D.S., P.A. All rights reserved. Disclaimer: The information provided within is intended to help you better understand dental conditions and procedures. It is not meant to serve as delivery of medical or dental care. If you have specific questions or concerns, contact your health care provider.
