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 doctor and the financial coordinator.