New Dental Patient Information
Dental Patient Registration Information
Before we begin your first appointment, we’d like to get to know you. Taking a look at your history and other information helps us do just that, so we’d appreciate you filling out a few forms. If you’d like to complete these at your first appointment, just come in at least 15 minutes before your appointment time.
If you’d rather take care of registration before you come in, we’ve made it easy to do so if you’re even a little bit computer-savvy. Just download the forms by clicking on the “Information Packet” link below. Then print all the pages, complete the forms, and bring them with you to your first scheduled visit.
The forms are in Adobe Acrobat (PDF) format. If you do not have Acrobat Reader, you can download a free copy by clicking on the Adobe Acrobat link below.
|Download Adobe Acrobat Reader
If you have any problem getting the forms to print properly, please call our office at 317-867-0757. We will gladly mail or fax them to you.
Insurance and Financial Agreements
We accept most insurance policies and will submit claims as a courtesy to our patients, and we’ll work with you to be sure you receive the maximum insurance benefits to which you’re entitled. Please bring your insurance card with you to each appointment. If you have a PPO or HMO policy, and are unsure if our office is in-network or out-of-network in your plan, please call our office staff. We’d be happy to help, as always.
Dental insurance covers some, but not all costs of your dental care. Most plans include a deductible, coinsurance, or other fancy insurance words that mean some expenses are your responsibility. For charges not covered by insurance, we can accept Visa, MasterCard, and American Express in addition to cash, check, or debit card as forms of payment. We ask that you make these payments at the time of service, unless you have made previous arrangements with our office staff. If needed, third party financing options are available through Care Credit Finance. Please feel free to discuss these options with our office manager during treatment coordination. We’ll be glad to assist you in any way we can.
We are here for you every weekday, with some evening hours:
Fridays 8am-1pm (alternating)
If you have a dental emergency after our normal business hours, you can reach Dr. Friedman by pager. Details are on our after-hours voice mail message, which you’ll reach whenever you call after hours.