New Patients

New Patient Forms

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Visiting us for the first time? We strive to make your appointment as stress-free as possible. So, once you book your consultation, you can fill out our new patient forms in the comfort of your home, meaning less time in the waiting room.

New Patient Forms

Download the forms below for print and fill them out before your first appointment to save time in the office.

CHURCH FAMILY DENTAL PLAN

ANNUAL MEMBERSHIP FEES

$449.00
adult

$649.00
couple

$299.00
child

MEMBERSHIP BENEFITS INCLUDE:

  • Regular Dental Checkups
  • Comprehensive Exam
  • Two Regular Dental Cleanings per Year
  • Oral Hygiene Instruction
  • Periodontal Evaluation
  • Fluoride Treatment
  • Digital X-Rays (when necessary)
  • Oral Cancer Screening
  • TMJ Screening
  • 2 Emergency Exams per year with digital x-rays (if necessary)

25% DISCOUNT OFF OUR USUAL AND CUSTOMARY FEE-EXCLUDES WHITENING, AND BOTOX

Download plan details

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