Policies & Forms

Appointment

Once you have made an appointment at our office, we reserve that time exclusively for you. If, for some reason, you can no longer make your appointment, please call us as soon as possible so that we may arrange a time that works for your schedule.

Payment

For your convenience, we accept cash, checks, CareCredit, and all major credit cards.We accept most dental insurance plans and our staff will work hard to help you get the maximum coverage allowed by your insurance benefits. Simply bring your insurance card to your first visit and we will be more than happy to call and verify your coverage.

Care Credit

CareCredit is a charge account that is easy to use, takes only minutes to apply and is ideal for all treatment costs not covered by insurance. It gives you low monthly payments with no annual fees, and you can use it for the whole family. 

Forms

If you are a new patient, feel free to print and fill out the patient registration and new patient medical history forms below before your first appointment to our office.

 

New Patient Medical History

New Patient Registration Form

Consent Form - Front

Consent Form - Back

Notice of Privacy Practices

East Location

6250 Poplar Avenue
Memphis, TN 38119
Office Phone: 901.681.0011
Fax: 901.681.9725

East Location

map

Midtown Location

266 S. Cleveland, Suite 103
Memphis, TN 38104
Office Phone: 901.728.6515
Fax: 901.728.4005

Midtown Location

map