New Patient Registration

We are committed to providing you with the best possible care. Prior to scheduling an appointment, we do our best to screen for health concerns that may affect the care of the patient. This may require your physician to give clearance before a dental cleaning is performed.

Our standard fee of $200 includes: 

  🪥  Home visit (May be more depending on the distance)

  🪥  Dental cleaning (Regular and Deep cleanings)

  🪥  Oral cancer screening

  🪥  Intra-oral Camera Photos

  🪥  Decay management/Tooth desensitizer application (Silver Diamine Fluoride)

  🪥  Topical anesthetic application (Gingicaine gel and Synapse Dental Pain Eraser)

  🪥  Denture cleaning (A new denture brush and tablets are dispensed after appointment)

  🪥  Nutritional counseling/Oral hygiene instruction

  🪥  Mobile dentist referral

  🪥  Dental hygiene treatment summary/invoice

We bring our own suction/air-water unit, infection control materials and any necessary instruments and supplies for the home visit. Instruments are properly sterilized after each patient and we don proper PPEs to protect our patients from cross contamination.

Payment for services is due at the time services are rendered. We accept cash, checks, credit cards and Zelle. We will be happy to process your insurance claim form (PPO) as a courtesy. Since we are an out-of-network provider, most insurance companies pay a percentage of our accepted fees. The percentage may vary by the type of procedure.  

We understand that emergencies happen but please allow for 48-hour advanced notice if possible.

If you have read and agree with the above, please download the forms below and complete them before the scheduled appointment. 

📝  New Patient Form

📝  Informed Consent Form

📝  HIPAA Agreement Form

📝  Policy Agreement Form