New Patient Form
If you would like to save time at your consultation appointment, you may download and fill out the required patient information forms prior to your appointment. You can either send the forms to us or bring them with you to the appointment.
If you are unsure of your orthodontic insurance benefits, please send or call us to give us your insurance information to verify your benefits prior to your appointment.
We will need the following information for insurance verification:
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Insurance name
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Subscriber name
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Subscriber date of birth
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Employer's name
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Patient name
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Patient's date of birth
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Member ID or SSN
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Group number if applicable