| Welcome to our office for a consultation. Please take a few moments to review the patient history form. You may download the form and print out a hard copy. Please answer the questions and bring the form in with you to your scheduled appointment. If you have had any dental x-rays taken within the past year please bring them with you or have a hard copy sent to our office prior to your appointment. We may require a panoramic radiograph which shows the upper and lower jawbones.
The fee for the consultation is $75.00. If you have dental or medical insurance we will submit the information to your insurance company for possible coverage of the service. If you have dental insurance please bring a completed insurance form with you. However, payment is always due the day services are rendered unless other arrangements are made prior to the appointment. We are located in the Sarasota Medical Center next to Doctor's Hospital in Sarasota. Please use the complementary parking valet. If you have any questions, please call us at (941)379-4244. We look forward to meeting you and serving your needs. Please fill out the registration form to the best of your knowledge. All patient information is confidential PATIENT HISTORY/REGISTRATION FORM |