Patient Forms

Patient Forms

New patient forms can be downloaded to your computer, printed and filled out at home. Completing forms ahead of time will save you time in our waiting room. If you have any questions, our office administrator will happily assist you on the day of your appointment.

Patient Forms

Tongue + Lip tie :

Sleep Screening For Children :

Myofunctional Screening Checklist :

  • Myofunctional Screening ChecklistDownload

Financial Information

Every insurance plan is different. It is a contract between your employer and the insurance provider. Understand your insurance coverage to guide you in selecting the treatment options presented to you by the dental clinicians. Most major work is not covered at 100% and some companies do not cover any major treatment. Even when you have two insurances, your basic treatment may not be covered at 100%. We encourage you to contact your insurance company personally, they will not communicate with the dental offices directly. Know your coverage, ask these key questions:

  • How many scaling units are covered per year?
  • On what interval are my recall exams covered?
  • Do I have an insurance maximum? Is it per annum or calendar year?
  • What percentage do I have for basic restorative coverage? (i.e. dental filling, root canal and extractions)
  • Do I have major coverage? If so what percentage and what maximum? This is coverage for crowns, dentures and orthodontics.

Predetermination Policies

The office will request from you insurance company a pre-authorization for dental treatment prescribed by the dental clinicians. The process may take a few day to a few weeks. Your insurance company will be in direct contact with you via email or post office with a response to your claim. Once you have a response you can call the office to schedule an appointment. Laser Dentisty & Photobiomodulation Clinic accepts cash, debit, e-transfers, visa and Mastercard for your co-payment. We electronically file insurance claimes and payment will directly come to us if your policy allows for this option.

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