PATIENT INFORMATION

First Visit

We will ask you to complete a medical and personal history form so that we will be able to get to know you better. Your initial appointment will consist of:

* Meeting the doctor and staff

* Full mouth dental and periodontal exam

* Oral cancer screening

* Only necessary radiographs (x-rays) to fully diagnosis your mouth's condition.

A comprehensive treatment plan, once formulated, will be fully explained to you so that you will understand the proposed treatment. Cost of dental procedures and any estimated insurance will be discussed.

We try to see each of our patients on an appointment basis and make every effort to schedule our patients so they will not be kept waiting. We realize that your time is important. If you have an emergency, we will do our best to take care of you as soon as possible. Our practice administrator, Janice Dickerhoff, will be happy to address any questions or complaints you may have.

Please contact our office if you are unable to keep your appointment. Your courtesy makes it possible to schedule other patients who wish to be seen. We reserve the right to charge for appoinments cancelled or broken with less than a 24-hour notice for a non-specialty appointment or 48-hour notice for a specialty appointment.

For your confidentialty and protection, we adhere to HIPAA (Health Insurance Portability and Accountability Act) and infection control procedures known as universal standards. Our office meets or exceeds all government required standards for sterilization. All instruments and handpieces are heat sterilized. We pride ourselves on the attention we pay to the cleanliness of our facility. This is yet another way that we strive to assure your continued health.

Dr. Dickerhoff and his staff look forward to welcoming you and your entire family to our practice. We can provide you the very best in affordable, gentle, and thorough dental health care. If you have any questions regarding treatment, please do not hesitate to ask. Our friendly and knowledgeable staff will always be happy to address your concerns.

Please assist us by providing the following information at your initial appointment:

* Your referral slip and any X-rays if applicable.

* A list of medications you are presently taking.

* If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you

process any claims.

IMPORTANT: A parent or guardian must accompany all patients under 18 at all times.

Please alert the office if you have a medical condition that may be of concern prior to treatment (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.) or require medication prior to dental cleanings (i.e antibiotics, for pre-med.)

X-Rays

If your previous dentist has taken recent x-rays (within 6-months), you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional films are necessary, they can be taken at our facility.