New Patient Information
At Total Mouth Fitness, your first appointment includes a thorough exam and gathering any information that our dentist must be aware of in order to provide care specifically to your oral health. We understand that all patients are different and require individualized care.
ADULT PATIENT FORMS
Thank you for selecting our dental healthcare team. Please complete the following patient forms prior to your appointment.
Welcome Patient Form (18 & over)Notice of Privacy Practices (HIPAA)
Health Questionnaire
Oral Cancer Screening Consent Form
No Show and Cancellation Policy
CHILD PATIENT FORMS (17 & under)
Welcome Child Form (17 & under)Notice of Privacy Practices (HIPAA)
No Show and Cancellation Policy
We are out-of-network with all insurance carriers.
As a courtesy, we submit claims on your behalf, and your insurance provider will reimburse you directly according to your plan’s benefits.
Membership Plan
For patients without dental insurance, we offer a simple membership plan designed to support ongoing preventive care.
Payment Options
Payment is due at the time of service. We accept cash, credit, and debit cards. For added flexibility, we partner with third-party financing providers to offer payment plans for qualified patients.
What Every Patient Can Expect
At our practice, every patient can expect to be treated with prompt service at their specified appointment time. Our patients can also look forward to a comfortable experience. We understand that visiting a new dentist can be stressful, which is why our practice works actively to accommodate all patients and alleviate any fears they may have about a new dentist or dentistry treatments. Familiarizing yourself with our practice, services, and our dentist is a great first step to creating a long term and comfortable experience with dentistry.
