FORMS New Patient Form (right click to save) (forms are in .pdf format, click the above link if you need software to view pdf files) Office Policy As we are strongly committed to provide “Dentistry with Integrity” we feel comfortable in our position to ask a patient to make a commitment in return; remuneration for our services and a life long commitment to good dental health. We do offer options regarding payment for dental services to help make your commitment to dental health a little easier. Cancellation Policy We make every effort to book your appointments at a time that works best for you. We will also confirm your appointment a few days prior to your appointment to remind you of the date and time you scheduled. We ask that you respect our time as we respect yours, if you can not come to your appointment please cancel it at least 24hours in advance so that we will have a chance to make the changes necessary. If you fail to cancel your appointment and do not show for your appointment we do reserve the right to charge you accordingly for time we have lost. Payment Options Payment for all services and treatment is expected upon completion. Regardless of the payment arrangement you have made please be aware that ultimately you are financially responsible for the high quality dental treatment you receive in our office. If you have questions regarding the costs of the treatments we have recommended we suggest you discuss your concerns with our treatment coordinator prior to your appointment, just call 403-320-0033 to set up a meeting during regular office hours. Standard Payment Options We are happy to accept Visa, MasterCard, Debit Card, American Express, Cash and Cheque. Insurance Our office is happy to submit dental claims to your insurance provider on your behalf when possible. When we submit a claim to your insurance provider you are responsible to pay any amount left owing or co-pay prior to leaving the office after your appointment. Even if you have “100%” coverage please keep in mind that your insurance company will cover 100% of the fee that they decided on, which is generally a lower fee than the majority of dentists charge. In order to take advantage of this option you must come to your appointment with all your most current insurance information. If for any reason your insurance policy changes and you fail to update the information on file you will be responsible to pay for the treatment that we are unable to submit, submitting the claim will then be your responsibility. When we recommend treatment your dental insurance coverage does not influence our recommendations or professional opinion. We will strive to utilize your insurance coverage to your best advantage, often we can stage your work over time to help you budget financially for large amounts of work. Extended Payment Plans We are pleased to offer all patients the option of extending payment for their treatment over a period of 3 months to 5 years with approved credit; this is a wonderful option for anyone looking at an extensive amount of dental work being done in a short period of time. These options are offered so that you can begin treatment right away and enjoy flexible financing to suit your budget. These payment plans are offered through Care Credit Canada. If you would like more information on the plans available please click on Care Credit and review their webpage or contact our office to arrange for a consultation or to discuss this option in more detail. http://carecredit.ca/ (link to care credit Canada) If you have any questions regarding the information provided about payment options please feel free to contact us.     521 6th Street South, Lethbridge, AB, Canada T1J 2E1 site design