Patient Registration Form
Insurance & Payment Policies
Our office is an out-of-network provider with dental insurance carriers. We are not a Medicaid or Medicare provider. However, we gladly file your dental insurance as long as you are able to choose your dentist. We will allow assignment of benefits to our practice. Estimates of expected co-pays are always discussed with patients prior to providing services, so you are able to make a fully informed decision. Co-payment’s are due at the time services are rendered. Please understand these are only estimates and we do not know with certainty the exact amount your plan may cover and that obligation of payment remains with the patient.
Financing
In an effort to provide exceptional dental care to all in our area, we are proudly partnered with Cherry and CareCredit which offers affordable payment options for our patients.
We accept Cash, Check, Visa, MasterCard, American Express and Discover.
Let’s make your first visit as easy as possible.
Book Your Appointment
CALL or e-mail INFO@COPELANFAMILYDENTAL.COM and we will answer any questions you have and schedule an appointment for you. If you are having a dental emergency call us right away.
New patient Forms
DOWNLOAD our intake forms and fill them out at your convenience. Email them to us or print them out and bring them with you.
Payment Options
We accept Cash, Check, Visa, MasterCard, American Express Cherry and Care Credit.