Fill in your forms before you arrive
Print your new-patient paperwork, fill it in at home and bring it to your first visit, and check-in goes faster. If you'd rather, fill it in when you arrive. We'll have copies ready.
What you'll fill in
Open the new-patient paperwork (PDF, 4 pages)
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Patient registration
Your contact details, your general dentist, an emergency contact and your dental insurance, with your permission for us to file your claim.
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Health history
Your medical conditions, the medicines you take, any allergies, and your physician's name and phone number.
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Financial policy
How we file your insurance claim, the payment methods we accept, and our missed-appointment policy.
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Root canal therapy consent
The alternatives to root canal treatment and its risks, so you can make the choice that's right for you.
How to fill them in
- Open the paperwork and print all four pages.
- Fill them in completely, in ink, and sign where asked.
- Bring them to your first visit, with a list of every medicine you've taken in the past month, prescription and over-the-counter.
If a question on the forms has you stuck, call us. Our team will help.
Or fill them in when you arrive
If printing isn't convenient, complete your forms at the office. We'll have copies ready for you.
Either way, please bring your list of medicines and your dental insurance details.
Paying for your treatment
We accept all dental insurance plans, and we file your claim for you.
We accept cash, check, Visa, MasterCard, Discover and CareCredit.
For dentists referring a patient
Send your patient with our referral card, or fax the referral to (270) 904-4415. After treatment, we send you a report of the visit, and your patient comes back to you for the final restoration.
Call today, and we will find you a time
Our team answers during office hours. If you are in pain, tell us, and we will make every attempt to see you the same day.
901 Wilkinson Trace, Suite 2, Bowling Green
Monday to Friday, 7:30 am to 4:30 pm