New Patient Forms

Save time on your first appointment by filling out forms ahead of time

Before you have your first appointment you will have to fill out some forms.  To save time at the clinic, we have provided them here so you may fill them out ahead of time.  Please print and fill these forms out and bring them with you to your first appointment.


It’s easy to apply online in the comfort of your own home. If any questions ask our front desk team for more information.

The initial examination is free of charge (a $157.00 value).

The in-office diagnostic records are also free of charge (a $295.00 value).

We offer a variety of payment plans, including no down payment with third-party financing, and no-interest financing options through our office to meet the various needs of our patients. Payments can be made by cash, check, most major credit cards, automatic monthly payments on your credit card, and if desired, you can make arrangements for third-party financing through CareCredit. You can also use CareCredit’s payment calculator to help determine your possible monthly payments.

We will work to build understanding and trust through open communication about your oral condition. Next, we will explain our findings and recommendations to help determine the most appropriate course of treatment. The goal of Prevention Dental is complete and accurate information aiding in your making informed dental decisions.

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Insurance providers and payment terms

Our office is committed to helping you maximize your insurance benefits. Many insurance policies have a lifetime orthodontic benefit which is different from regular dental insurance. Since insurance policies vary, we will review your insurance to help you maximize the use of your benefits.

We are currently on assignment with Ameritas, Blue Cross-Blue Shield, Cigna, Delta Dental, Humana, Lincoln Financial, MetLife, Principal, Unicare, and United Concordia.  Also, we will process your insurance paperwork for you as part of the assignment. As a courtesy to our patients who have insurance that we’re not on assignment with we will assist in billing your insurance company for services rendered. To help us with your insurance filing please complete the insurance information form.

If you have any questions, our courteous staff is always available to answer them.

Schedule Your Appointment Today!