Our commitments

We have often being given compliments on how well our office is run and the superior experience patients have. We feel it is important to share information with you on ‘how and why’ our practice prides itself on spending quality time with each individual patient and provide quality dentistry at reasonable costs. We do this by having both office staff and patients abide by certain commitments. We have put them in writing because we live by them and in order for us to deliver this quality experience in our office we request that our patients live by them as well. We ask that you read this thoroughly to become familiar with them.

Commitment of treatment policy

We believe that all treatment begun should be completed. Incomplete treatment leads to problems, complications and misunderstandings. Incomplete treatment leads to loss of teeth and further disease. Therefore, this policy states that all agreed to treatment plans will be completed. Some treatment plans, because of their design or complexity, may take several years to complete. However, to begin staged treatment, your commitment to both starting and completing treatment is necessary.

Commitment of appointment policy

We reserve time for each patient and rarely do we keep our patients waiting. An appointment written in our schedule with your name on it is a bond of trust that we will be here to serve you and you will be present for that appointment. Therefore, you are expected to keep your scheduled appointment time. With a mutual respect for each other's time, should there be a completely unavoidable change in your schedule, we expect at least a day's notice.

Commitment to financial agreement policy

We believe we have a responsibility to use our best professional care, skill and judgment in planning and providing your dental treatment. All fees and financial arrangement options will be explained to you so that you may fulfill your financial commitment promptly and completely. We will assist you in receiving any benefits due to you from your dental insurance, however your contract is ultimately between you and your insurance company. We can not guarantee payment of their portion. We can only guarantee the best of care. No business or practice can fulfill its mission to it's patients when a bond of trust is violated by failure to pay for services.

Our office does not diagnose, render treatment or establish fees according to any insurance tables or allowances. Office fees are based on care, skill and judgment of the professionals delivering the services, and by the cost of operating a dental office dedicated to excellence. Please remember that we work 100% for YOU, not the insurance company. Your dental plan may only cover charges for the least expensive results. We refuse to compromise our standards by offering anything less than the complete care that you deserve. We will file insurance claims as courtesy to you. Please understand that YOU ultimately responsible for any amounts not covered by your plan.

I have read and thoroughly understand the above statements.

To print the pdf form and sign it please click here.