PHONE:
909-383-8931
| ADDRESS:
1881 Business Center Dr Ste 7A, San Bernardino, CA 92408
CALL US NOW:
909-383-8931
ADDRESS:
1881 Business Center Dr Ste 7A,
San Bernardino CA 92408
RESOURCES
PATIENT FORMS
Our friendly staff is looking forward to helping you achieve healthy teeth and gums for life in an inviting atmosphere. If you would like to streamline the process of beginning your treatment at our clinic, please feel free to download and fill out the following forms. When you come in for your appointment with these forms filled out we will likely be able to begin your appointment quicker.
2 - Medical History Form
3 - Acknowledgement of Receipt of Notice of Privacy Practices Form
4 - Informed Consent Form & Information Form
5 - Patient Information & Office Policies
6 - Notice of Privacy Practices
FINANCIAL ARRANGEMENTS AND DENTAL INSURANCE
We have established the following policy for our patients: payment is expected at the time of service. Cash, Personal checks,
Visa, MasterCard, Discover, American Express and Care Credit.
A 10% discount is offered to Seniors without insurance.
We are happy to file your insurance for you. We require that you pay your portion due at the time of service. If you have further questions, please call our office and one of our assistants will be happy to answer them for you.
A 10% discount is offered to Seniors without insurance.
We are happy to file your insurance for you. We require that you pay your portion due at the time of service. If you have further questions, please call our office and one of our assistants will be happy to answer them for you.