New & Existing Patients
You may preregister with our office by filling out the secure online Patient Registration Form below. After you have completed the form, please make sure to press the Submit button to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Reminder: Please bring a photo ID, medical and dental insurance cards, referral documentation, and all forms.
Important Information for New Patients
To help protect you from becoming a victim of identity theft, our practice will verify the identity of all new and returning patients of the practice.
Additionally, federal law requires all healthcare providers to obtain, verify and record information that identifies each new patient.
What this means for you: when you fill out your paperwork, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
Nu Image Financial Information
Financing Options for Oral Surgery
We offer the most convenient financial options in addition to providing excellent surgical care. Learn about all the financial options you have before you plan your surgery with us to make an informed decision within your allowed budget.