Financial Policy Financial PolicyFinances are a concern for many of our patients. We understand this concern and are happy to offer a number of payment options. Cash, check, or credit cards such as Visa, Discover, MasterCard, or American Express are accepted at the time of service. We also accept financing plans through CareCredit and can help you apply right here at the office. If you have dental insurance, we will file a claim to your insurance carrier as a courtesy to our patients, but we cannot guarantee what they will, or will not provide payment for. If a treatment plan is generated, we can also file pre-determinations with your insurance carrier to determine what your financial responsibility will be at the time of service. An accounting discount of 5% will be granted to patients whose treatment plan totals over $500 and who wishes to pay in full the day the treatment is presented, or in advance of scheduling their appointment. Payment for services rendered is expected at the time of service. Debt that is unpaid after one month from the date of service will be considered delinquent and will be subject to a 5% late penalty. Accounts that are over two months late may be referred to a collection agency. We sincerely apologize for any inconvenience this may cause. As a small, private dental office we are unable to provide in-house financing of treatment. Thank you for your understanding. First Name Last Name Email Address Signature* Reset signature Signature locked. Reset to sign again Date* MM slash DD slash YYYY CAPTCHA