Need an appointment?

Your NEW PATIENT EXAM is a detailed examination with the doctor. A full mouth series (FMX D0210) and Panoramic x-ray (D0330) is required for every new patient at our office.

If you have a shared frequency clause in your insurance plan, you will likely have to pay out of pocket for one out of the two required x-rays.

A new patient exam is required before your first dental cleaning in our office.

 

For Patients of Record:

For patients that have already had an exam with the doctor. This form is not for new patients.

If you have an active treatment plan, please request an appointment below, text us, or give us a call at (321) 319-2302.