Patient Forms and Resources
Sangiv I. Patel, D.D.S., PA
Dr. Patel and his staff are dedicated to providing you with a pleasant visit and results that you’re proud to show off. Our administrative staff is ready to help you with questions about scheduling, financial policy, and insurance to make that part of the process as simple as possible.
First Visit
Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, treatment can be done the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.
Please fill out the Patient Registration Forms:
New and Existing Patients – Please complete all four forms
Please assist us to provide you with the best care possible by submitting the following information prior to your appointment:
- Any x-rays or records you would like transferred from a previous office.
- A list of medications you are presently taking.
- Your dental insurance details, as this will save time and allow us to help you process any claims.
IMPORTANT: A parent or guardian must accompany all patients under 18 at the consultation visit.
Please alert the office if you have a medical condition that requires medication prior to dental procedures (i.e. antibiotics for premedication).
Patient Resources
Our staff looks forward to meeting you and discussing your goals. We strive to keep our appointments on time as scheduled. Prior to your appointment, we encourage you to fill out the patient forms that are located on this website so you can accelerate your check-in process. If you prefer to register in person, please arrive 20 minutes early to your appointment so you may have ample time to fill out the appropriate forms.
Financial Policy
We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered. For patients with dental insurance, we are happy to work with your carrier to maximize your benefit and directly bill them for reimbursement for your treatment. Please remember we try our best to estimate ahead of time what benefits will be paid, however, this is not a guarantee of payment on their part. The patient is ultimately responsible for any unpaid portion remaining on their account.
For your convenience, we accept cash, check, Visa, Mastercard, Discover and American Express. We also offer a differed or low interest payment option through Care Credit.
CareCredit is a company that provides patients with credit for elective procedures, offering short-term, 0% interest payment plans and low-interest, extended payment plans. CareCredit has no up-front costs, no fees, and no pre-payment penalties.
If you have questions regarding your account, please feel free to contact us.
Please provide us with your insurance information prior to your first visit, so that we can expedite reimbursement.
