Web Only Limited Time Offer
New Patients Only
$50 out of pocket savings off of a new Patient Experience
(includes, New Patient comprhensive exam, Panoramic and Decay detecting x-rays and consultation)
**Must bring this coupon/or completed New Patient Forms in for savings
Website Offer Only
Limited time offer
$199 Opalescence Take home bleaching kit (reg $498)
**Must bring this coupon in for savings
| NEW PATIENT FORMS | HIPAA FORMS |
| New Patient Information | Notice of Privacy Practice |
| Insurance Information | Acknowledgment of Receipt |
| Medical and Dental Info | Consent for Release of Information |
| Medical History Update | |
| Financial Policy | |
| PATIENT INSTRUCTIONS | INSURANCE PROVIDERS |
| Click Here to View Our Patient Instructions |  |
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