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Welcome New Patients
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Please help us be prepared for your first appointment by completing this Patient Information and Medical History Form.
Download and print the form, fill it in, and return it to our office.
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>> PDF Format
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| My staff and I welcome you to our orthodontic practice! Our goal is to create beautiful healthy smiles as well as balanced faces that will last a lifetime.
Our office continually strives to provide the best quality care for each patient. We maintain a professional, yet fun atmosphere that provides state of the art orthodontic treatment. With the use of digital imaging, advanced computer systems and interactive software, we are able to make a more thorough diagnosis and a better treatment plan for our patients. These tools are extremely helpful in allowing the patients to visualize the problems and their solutions. We offer the latest technology in orthodontic appliances and sterilization/disinfection procedures.
 We pride ourselves in actively pursuing new knowledge and technology that will better serve our patients. NEW PATIENTS ARE ALWAYS WELCOME AND WARMLY EMBRACED!
Initial Visit
At your initial visit Dr Hughes will:
- Actively listen to your concerns and needs
- Examine your teeth and jaws
- Review your digital photos and Panorex x-ray
- Present treatment options
- Educate you on the treatment process
- Offer several flexible payment plans
There is no fee for the initial exam and consult; however there is a fee for additional diagnostic records.
Beautiful, Healthy Smiles Gentle on Your Budget
The actual cost of orthodontic treatment depends on the severity of the problem. Our fees are based on the treatment that needs to be accomplished, and not the length of time or number of visits required to achieve the desired results. We offer flexible payment schedules and accept assignment of benefits from most insurance companies.
Orthodontics is a true investment in yourself. The rewards of improved health, confidence and self-esteem will last a lifetime.
Payment Options
- Orthodontists Fee Plan (OFP) is a financing plan that offers payment arrangements without a down payment. Monthly payments can be arranged for up to 60 months with a competitive interest rate. The American Association of Orthodontists has endorsed OFP. You can visit their web site at www.orthofeeplan.com.
- Our in-office payment plan consists of an initial down payment with the remaining balance divided into equal monthly payments, without interest. We accept Visa, MasterCard, Discover and American Express.
- We offer online payments and automatic credit card payments.
- As an added bonus, we offer an accounting discount for payments made in full at the start of treatment.
Insurance
As a courtesy and service to our patients, we will file insurance claims for you. Please bring all your insurance information so that we can process your claim. Please be aware of the following insurance facts:
- Orthodontic insurance is a separate rider to dental insurance. Having dental insurance does not mean that you have orthodontic insurance.
- Most orthodontic insurance is 50% of the total fee up to a lifetime maximum.
- Orthodontic insurance is usually not paid in one lump sum.
- If you change jobs, your orthodontic insurance payments may stop (unless your new job has orthodontic benefits). You would be responsible for the balance of the fee due.
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