{"id":370,"date":"2015-05-04T02:37:07","date_gmt":"2015-05-04T02:37:07","guid":{"rendered":"https:\/\/ncaestheticdds.com\/?page_id=370"},"modified":"2017-07-16T07:36:39","modified_gmt":"2017-07-16T07:36:39","slug":"forms-financial-policies","status":"publish","type":"page","link":"https:\/\/ncaestheticdds.com\/forms-financial-policies\/","title":{"rendered":"Forms & Financial Policies"},"content":{"rendered":"

[vc_row full_width=”stretch_row” css=”.vc_custom_1500190597395{padding-top: 30px !important;padding-bottom: 30px !important;background-image: url(https:\/\/ncaestheticdds.com\/wp-content\/uploads\/2015\/02\/bg_prpl.jpg?id=95) !important;}” fullwidth_row=”yes”][vc_column width=”2\/3″][vc_column_text css_animation=”right-to-left”]<\/p>\n

Patient Resources<\/h1>\n

Our first priority is our patients. Below you will find some documents that will help us help you.<\/p>\n

[\/vc_column_text][\/vc_column][vc_column width=”1\/3″][vc_icon icon_fontawesome=”fa fa-pencil” color=”white” background_style=”rounded-outline” size=”xl” align=”center”][\/vc_column][\/vc_row][vc_row css=”.vc_custom_1430708881298{margin-top: 40px !important;margin-bottom: 30px !important;}” fullwidth_row=””][vc_column][vc_column_text]If you are unable to make your appointment, we ask you kindly give 48-hour notice. Feel free to give our office a call if you have any questions. We look forward to working with you!<\/p>\n

Our business office staff will be happy to file your primary and secondary insurance for you. We request any deductible or co-pays to be paid at each visit. Please bring the completed forms and your insurance card\/information at the time of your visit. A parent or guardian must be present at the time of the appointment if the patient is less than 18 years of age.[\/vc_column_text][vc_row_inner][vc_column_inner width=”1\/2″ css=”.vc_custom_1430708749629{padding: 10px !important;}”][vc_column_text]<\/p>\n

New Patient Packet<\/h3>\n

It is our privilege to care for your oral health needs. We appreciate you selecting our office for your dental care. Please read and complete our New Patient Packet:[\/vc_column_text]

<\/i>Patient Information (HIPPA)<\/a><\/p>

<\/i>Medical History<\/a><\/p>[\/vc_column_inner][vc_column_inner width=”1\/2″ css=”.vc_custom_1430708739934{padding: 10px !important;}”][vc_column_text]<\/p>\n

Release Forms<\/h3>\n

To have your dental records transfered to or from our office; please complete and submit a records release form.[\/vc_column_text]

<\/i>Record Release (from our office)<\/a><\/p>

<\/i>Record Release (from another office)<\/a><\/p>[\/vc_column_inner][\/vc_row_inner][vc_row_inner css=”.vc_custom_1430708773542{margin-top: 40px !important;}”][vc_column_inner][vc_column_text css=”.vc_custom_1433650616041{margin-bottom: 10px !important;}”]<\/p>\n

Financial Arrangements<\/h2>\n

Our office is dedicated to providing you the best dental care. Payment of your bill is considered part of our treatment and it is important you understand our Financial Policy prior to any treatment.<\/p>\n

Forms of payment accepted: Cash, Checks, Visa\/Mastercard, Discover, American Express and CareCredit<\/a>.<\/p>\n

Our office files primary and secondary insurance as a courtesy. All current and complete insurance information will need to be provided at the time of service.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=”1\/3″ css=”.vc_custom_1432847635118{padding-top: 10px !important;padding-right: 10px !important;padding-bottom: 10px !important;padding-left: 15px !important;}”]

<\/i>Financial Policy<\/a><\/p>[\/vc_column_inner][vc_column_inner width=”1\/3″ css=”.vc_custom_1432847515675{padding-top: 10px !important;padding-right: 10px !important;padding-bottom: 10px !important;padding-left: 10px !important;}”]

<\/i>Secondary Insurance Policy<\/a><\/p>[\/vc_column_inner][vc_column_inner width=”1\/3″][vc_single_image image=”514″ img_size=”full” alignment=”center” onclick=”custom_link” img_link_target=”_blank” css_animation=”right-to-left” link=”http:\/\/www.carecredit.com\/apply\/”][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

[vc_row full_width=”stretch_row” css=”.vc_custom_1500190597395{padding-top: 30px !important;padding-bottom: 30px !important;background-image: url(https:\/\/ncaestheticdds.com\/wp-content\/uploads\/2015\/02\/bg_prpl.jpg?id=95) !important;}” fullwidth_row=”yes”][vc_column width=”2\/3″][vc_column_text css_animation=”right-to-left”] Patient Resources Our first priority is our patients. Below you will find some documents that will help us help you. [\/vc_column_text][\/vc_column][vc_column width=”1\/3″][vc_icon icon_fontawesome=”fa fa-pencil” color=”white” background_style=”rounded-outline” size=”xl” align=”center”][\/vc_column][\/vc_row][vc_row css=”.vc_custom_1430708881298{margin-top: 40px !important;margin-bottom: 30px !important;}” fullwidth_row=””][vc_column][vc_column_text]If you are unable to make your appointment, we ask..<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-full.php","meta":[],"yoast_head":"\nForms & Financial Policies - Carolina Aesthetic Dentistry<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/wordpress-660194-2211124.cloudwaysapps.com\/forms-financial-policies\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Forms & Financial Policies - Carolina Aesthetic Dentistry\" \/>\n<meta property=\"og:description\" content=\"[vc_row full_width=”stretch_row” css=”.vc_custom_1500190597395{padding-top: 30px !important;padding-bottom: 30px !important;background-image: url(https:\/\/ncaestheticdds.com\/wp-content\/uploads\/2015\/02\/bg_prpl.jpg?id=95) !important;}” fullwidth_row=”yes”][vc_column width=”2\/3″][vc_column_text css_animation=”right-to-left”] Patient Resources Our first priority is our patients. 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