Patient Information
What to Expect at Your First Dental Visit
Most importantly, we want to know what is important to you regarding your oral health. To us, your goals are the most important guide in creating a personalized treatment plan! The doctor will meet with you to discuss your X-rays, help you create your own individual treatment plan, and answer any questions that you may have.
In order to provide you with the best possible care, your first appointment will consist of the following procedures:
In order to provide you with the best possible care, your first appointment will consist of the following procedures:
- X-rays (Dr. requires x-rays that are within a year old)
- Exam and Charting of existing dental work
- Developing a treatment plan to suit your needs (including cleanings)
- Dr. Hazen will examine your mouth and diagnose your x-rays to determine the condition of your gums, teeth, and tissues.
- Oral Cancer Screening
Before Your First Appointment, Please Remember To:
- Complete your patient information form via the link we sent to you.
- Submit your insurance information to us at least 3 business days prior to your visit.
Fill Our Online Patient Forms Below
- Registration Form
- Acknowledgement of Receipt of Notice
- Insurance Filing Policy
- Notice of Privacy Practices
Insurance Policy
Our office is committed to helping you maximize your insurance benefits. Because insurance policies vary, we can only estimate your coverage in good faith but cannot guarantee coverage due to the complexities of insurance contracts. Your estimated patient portion must be paid at the time of service.We accept most PPO insurances. We do not accept any HMO plans, and we do not accept Medicaid/Medicare plans. Although we may estimate what your insurance company will pay, it is the insurance company that makes the final determination of your eligibility. You agree to pay all the charges not covered by insurance or all the charges deemed your responsibility.
As a service to our patients, we will bill insurance companies for services and allow them 45 days to render payment. After 60 days, you are responsible for the entire balance, paid-in-full. If you have any questions, our courteous staff is always available to answer them.
Appointment & Cancellation Policy
Appointments are an important part of your treatment, as time has been reserved specifically for you to talk with the doctor and receive treatment. Please arrive on time for your appointment. Please note that if you arrive more than 10 minutes late, you may be asked to reschedule.We do our best to accommodate our patients when it comes to scheduling a convenient appointment - but a missed dental appointment presents problems for both of us. For you, a missed appointment causes a delay in treatment that was recommended to help improve your dental health. And for our office, a missed appointment prevents us from scheduling another patient that could benefit from treatment. We schedule appointments customized to your needs and have reserved a room and staff to be available to allow us to deliver the quality personal care that every patient deserves.
We understand that things happen, and schedules do change, and for that reason we request you provide us with at least a 24 business hour cancellation notice prior to your scheduled appointment. Failure to provide us with this 24 business hour notice will result in a $50 fee if you were scheduled with the hygienist, and a $100 doctor fee if you were scheduled with the doctor.