Please verify with your dental insurance that we are in your network before your appointment.
Patient Registration Forms - Printed Version
In an effort to save paper, we will no longer be offering printable forms starting 8/1/22.
Patient Registration Forms - Online Version
Online forms can be completed easily and quickly on any smartphone, tablet, or computer!
X-RAY INFORMATION:
Your first cleaning appointment will include a series of x-rays taken of your mouth. We recommend taking a FULL MOUTH SERIES on all new patients over 30 years of age, or on patients who may require restorative work. For patients who are younger, or on patients that may require wisdom tooth extractions, a PANO and BITEWING x-rays are recommended. You may sign a waiver stating your refusal to have x-rays taken at your appointment.
As a courtesy, we will contact one office of your choice to receive recent x-rays. We would only be interested in bitewing x-rays under one year old, a PANO under five years, and an FMX under five years old. We will require the name and phone number of the office you would like us to contact.
If you wish to get the x-rays yourself, or have been to multiple previous offices, please have all relevant x-rays EMAILED to Vinkovichxra[email protected] Only emailed x-rays and original films will be excepted, no printed copies. (ASPEN PATIENTS ARE REQUIRED TO RETRIEVE THEIR OWN X-RAYS)
Some offices do require patients to sign a release form. We will contact you with further instructions if this is the case.
Please contact your insurance prior to your appointment to find out what x-rays you are eligible for if you are concerned about insurance coverage.