We are accepting new patients!
Welcome to Smiles by Design. Our primary goal is to create and maintain the dental health of our patients. We provide complete dental care and services from checkups and teeth cleanings to total smile makeovers including full mouth restorations. Please review our dental services for more information about procedures or call with your questions; you have come to the right dental practice.
The following patient registration and HIPAA forms can be downloaded to your computer and printed at home. In order for our physicians to provide a complete and comprehensive medical opinion it is important that we review all your medical information. Please be prepared to provide this information to our office along with your current medical insurance card and photo I.D. Below is a link to our patient registration forms. If you have any questions about these forms, our staff will assist you with your questions on the day of your visit.
Please print out these download-able PDF forms, fill them out and bring them with you to your first appointment.
Financial Policy & Payment
We understand that every patient’s financial situation is different. For this reason, we have a variety of payment options to assist you in receiving the dental treatment you need and want with respect to your budget.
Choose the way you want to pay.
While we believe in giving you lots of choices, there's one you shouldn't have to make: deciding between the dental health care you need and the dental health care you can afford. So we'll sit down with you to figure out which payment option makes sense for you for the dental services you need.
We accept all major credit cards.
Payments may be made using cash, check, ATM card and Visa, Master Card and Discover credit cards.
New Patient Offers
We are happy to submit insurance claims necessary to see that you receive the full benefits of your coverage. However, your insurance policy is a contract between you, your employer, and the insurance company. We are not a party to that contract; our financial relationship is with you, not your insurance company. Please know that we will do everything possible to see that you receive the full benefits of your policy. If for some reason your insurance company has not paid their portion within a reasonable amount of time, you are responsible for your balance. Fees for deductibles and co payments are due at the time of treatment. As we can only estimate what your insurance will pay, there may be a balance due after insurance pays.
For comprehensive treatment, payment can be made as each phase of treatment is commenced. A 5% discount is available if payment is paid in full prior to the start of treatment and if payment is made by check or cash (no credit card or office financing).
We are aware that unexpected dental care costs can significantly impact your budget. For this reason, we also offer dental financing that can extend anywhere from six months to five years. Our staff would be happy to explain these options.
Dental Services Financing
We also offer an extended payment plan through Care Credit, which is a financing option that is available only for healthcare expenses. Care Credit applications can be made through our office for 1) interest-free payment plans up to 12 months and 2) low interest payment plans of 24 to 60 months.
Care Credit Application
Prosper Healthcare Financing