New Patient Information

Thank you for choosing Orland Family Dental for your dental needs.  Please download & fill out applicable forms to bring to your appointment.  We look forward to seeing you.

HIPPA Notice of Privacy Practices (for your reference)

Adult Patients:  Medical History (Adult), Acknowledgement of Receipt of Privacy Practices & Confidential Communications, Financial Policy

Child Patients (under 13 years): Medical History (Child)Acknowledgement of Receipt of Privacy Practices & Confidential Communications, Financial Policy

  

If you have insurance, we will submit a form for you on your behalf. However, the patient (or responsible party) is ultimately responsible for payment. We accept the following forms of payment: Cash, Debit, Check, Visa, MasterCard, Discover, American Express, Apple Pay and Care Credit.

Payment for services is due at the time services are rendered unless prior arrangements have been made with the financial coordinator.


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