New Patient Forms & Payment Information
Get Your Form
The New Patient form is a PDF, which can be read using Adobe Acrobat Reader.
Click on the button below to download the New Patient form.
Be sure to print and fill it out ahead of your appointment and then bring it with you.
Payment & Insurance
Payment
Payment is expected at time of service. If you have insurance, you will be expected to make an estimated payment for that portion not covered by your insurance plan. For that portion of costs not covered by insurance, we offer several payment options:
- Cash or Personal Check
- Credit Card – We accept MasterCard, Visa, and Discover.
- Financing is available from Wells Fargo Financial. Call our office or stop by for details.
Insurance
Dental insurance is intended to cover some, but not all of the cost of your dental care. Most plans include coinsurance provisions, a deductible, and certain other expenses which must be paid by the patient at the time of services. Reimbursement amounts are not, and never have been, a guideline for quality care.
We can file most insurance claims for you. Please bring your insurance plan information with you on your first visit. We will work with you to ensure that you receive the maximum benefits to which you are entitled.
If you have any questions about your insurance plan or payment options, please call our staff at 434-974-4555 or e-mail us at info@drlbrannon.com.