Patient Forms

Family Dental Care accepts most major dental insurances. We are happy to process your insurance claims to maximize your benefits. Since insurance can be confusing, we ask that you call or contact us with specific questions. Because insurance policies vary, we can only estimate your coverage in good faith but cannot guarantee coverage due to the complexities of insurance contracts. As a service to our patients, we will bill insurance companies for services and allow them 45 days to render payment. After 45 days, you are responsible for the entire balance, paid-in-full. If you have any questions, our courteous staff is always available to answer them. 

Please click the link below to pay online using DentalPay.  A new browser tab will open with the form. 

https://app.dentalpay.ai/hosted_payment?pid=1727965716144x421328570064830460

WE APPRECIATE YOUR BUSINESS !

For fees larger than $300 we can discuss some payment options that may be available to you. There is no guarantee of credit being extended to anyone.  As a service to our guests, we are pleased to offer CareCredit, the nation's leading patient payment program.  For fees from $300 to $25,000, upon request and approval, CareCredit offers a comprehensive range of plans with low minimum monthly payments that fit comfortably into every budget. 

· Start treatment and care immediately and pay over time

· Pay for other medical expenses for you and your family without having to reapply

· Pay for deductibles and treatment not covered by insurance

· Have no annual fees

· Go to www.carecredit.com

· Fill out the application 

· Receive a decision immediately 

· Contact our practice to schedule treatment

Other financial payment options may be available, please ask for information on these products. You can pay for your office visits and any treatments by cash, check, credit or debit card at the time of treatment.

To discuss your payment options or insurance coverage, please call 

775-738-3500.