We have made our new patient forms available to you as Adobe Acrobat files. For your convenience, we recommend printing and completing these forms at home.

Please remember to bring your completed forms with you to your first appointment. If you have a problem getting these files to print properly please call our office, and we will gladly send or fax them to you.

Please Complete ALL Forms Below:

• NEW PATIENT QUESTIONAIRES (These forms do not need to be printed. Simply fill in your responses.)
• Notice of Privacy Practices (You may print these forms for your records only.)
• Financial Policy (Please print and bring with you.)
• Whitening for Life and Whitening Consent (If you are interested, please print and bring with you.)
• Acknowledgement of Receipt of Notices of Privacy Policies (Please print and bring with you)

Ultra Smiles Special:

Lumi Brite WHITENING: Whiter, brighter teeth in about an hour!!! Only $399

~Chair-side includes custom trays and take home 3 minute touch up whitening gel

~ Lumi Brite Complete Take Home Whitening Kit only $199

*** Take advantage of this limited time offer!

Our Mission:

~To create and maintain healthy smiles beyond the ordinary standard of care

Our Vision:

* To provide the highest quality care with the latest advancements in dental technology

* To deliver the very best patient service in a comfortable, relaxed atmosphere

* To develop long-term relationships by ensuring your dental care needs are met in a caring and honest manner

Copyright © 2011