Our goal is to provide you with the best possible dental care and to avoid any misunderstandings. We
encourage our patients to discuss any questions they may have regarding our policies. If any problems
arise, please discuss them with us promptly. The following is a statement of our financial policy, which
we require that you read and sign prior to any treatment:
We require that payment be made at the time of service. Payment can be made by cash, check, and most major credit cards
(NSF charge of $35 for any returned checks)
If the cost of treatment is $500.00 or less, the entire amount is due in full at the time of the
Initial treatment Is performed.
If the cost of treatment is
greater than $500
, we can discuss our
(with regards to your
treatment plan) at the time of your consultation.
After Final Treatment, a FINANCE CHARGE OF 1.5% PER MONTH (18% PER ANNUM) shall be charged on all account not paid within 90 days after billing date, and/or your unpaid account may be assigned to our collection agency (Effective 6/1/09).
Patient Identification Policy - (Effective 5/1/09) - Federal law requires all healthcare practices to
obtain, verify, and record information that identifies each patient. Therefore, we will obtain
a copy of your government issued ID and we will take a photograph of you to place in your