Our philosophy is to provide the highest quality of patient education and dental care to all patients that choose us for their dental care.  By providing you with the following information, we hope to prevent misunderstandings to ensure you encounter a positive experience.

Please let us know if you have any questions or concerns.

Expected Payment

To keep our fees to you as low as possible, we ask that payment be made at the time of scheduling.  Please allow approximately 60-90 minutes for your initial visit.  If you have pain or an emergency, every attempt will be made to see you that day.  During your consultation, it may be necessary for an additional 3D scan for accurate diagnosis; should the scan be necessary, an additional fee of $450** will be assessed in addition to your consultation fee.  For your convenience, an estimate for services/treatment plan will be prepared during your consultation, in advance of your appointment/s to ensure your opportunity to plan for your dental care.  Whether you privately pay or have dental insurance to assist you, everyone deserves the care they need and want.  Therefore, it is necessary to provide accurate insurance information so estimates can be as accurate as possible.                   

You can begin by filling out your Medical History Financial Data Forms.

The forms will ask you for your complete medical history and the following information to become a patient of record:

1.  Name-Your full legal name and your nickname.

2.  Phone Number-Work and Home/Mobile

3.  Email

4.  Date of Birth

5.  SSN and ID (ODL, Passport, etc)

6.  Insurance information (carrier, group/policy#)-we will bill them/they pay you in most cases.

7.  Employer and any other HIPAA contacts

8.  Medication and Medical History

About your SSN: We require this information for the patient, the guarantor of the account, the subscriber, and anyone authorized to pay on the patient’s account. 

We often need this vital piece of data with Federal Plans, those who have served, and many systems, including debt collection, still require it to help patients collect payment for dental healthcare services by verifying their identity when looking up their health records and communicating accurately with other dental and medical offices.  The internet has helped lend to this paranoia that dentists do not need this information, which is inaccurate.  Due to the monumental headache we run into when we can not collect this information, you can refuse to provide this, and we will always collect cash (no credit/insurance billing) to serve your needs. However, you will need to bill your dental insurance, and you will not be able to pay with credit/debit.

Please ask us on your first visit if you need special accommodations for your schedule.  Suppose you require anyone to be present to help you make decisions and pay for the treatment at your exam (parent, spouse, guardian, please bring them to your visit, but leave all other children, friends, fur babies, etc., at home.  Licensed Service Animals are allowed, but no emotional support animals sorry!) 

Dental Insurance

We are an unrestricted provider of dental insurance.  We are not in-network with any insurance, which means they don’t dictate the best care for you.  If you need an in-network provider, call your insurance to help direct you.  Our office collects in full for your visits when scheduling, and afterward, we can bill insurance for you once you become a patient of record.  Your insurance will send you the check. 

Your dental insurance company will only pay for a portion of your dental care, and cosmetic procedures are usually not covered.  Therefore, patients should consider saving money for dental care, like retirement or a house.  Our office is pleased to offer interest-free financing for those that qualify through Care Credit.

We are happy to file your dental claims to assist you in receiving the full benefits of your coverage.  However, we request that you be familiar with your insurance benefits and provide us with the correct information within 30 days of your appointment to assist you with submitting claims.

We ask for your insurance benefit to be sent to you and collect our full fees from scheduling your treatment with our office.  In addition, we offer a complimentary benefits check once you become a patient if you would like us to find out what levels of coverage you will have with us. 

We cannot bill some insurances: Oregon Health Plan (OHP Waiver), Medicare/Medicaid, Kaiser Permanente, Willamette, BCBS/Premera, any/all Medical insurance, and certain Federal Plans.  For the plans mentioned above, it would be best for you to contact them on how you can file your claim.

Please realize that your insurance is a contract between you, your employer, and the insurance company; therefore, we cannot guarantee coverage or eligibility, and your assistance may be requested to expedite the processing of your claim.  In addition, not all services are covered benefits in all contracts; therefore, you are ultimately responsible for the total amount of your dental fees.  Therefore, the treatment recommended for you is indicated regardless of your dental insurance benefits, deductible, limitations, or maximums.

If you have questions about the cost, please bring those with you to your first visit, and we’d be happy to answer those questions at that time.  


We consider all appointments confirmed when they are reserved.  We do not double book with anticipation of patients not showing up for their needed dental care.  Our schedule remains open yet, fully staffed when patients cancel or fail the same day of their appointment.  We require a 7-day advance courtesy notice for all non-surgical appointments, allowing us to reappoint at a more convenient time for you and have sufficient time to offer your appointment to another patient.  Failure to cancel before that window will incur a $75 cancellation fee for all non-surgical appointments.  All surgical appointments require a 7-day advance courtesy notice.  Failure to do so will result in a $100 or 10% of the surgical Fee, whichever is greater, for all surgical appointments without seven days of notice.  Cancellations must be made via phone call and during business hours.  Messages left on voicemail, via email, or text will be deemed inadequate and assessed the appropriate Fee.

Cell Phones

We ask that cell phones be turned off while in the treatment area.  However, if being available for an emergency during your reserved appointment is necessary, please leave our office phone number so you can be reached.  Should an unfortunate emergency arise, we would be happy to notify you in the treatment area immediately.                                                                 

Information Changes

To ensure your records are current, please notify us of any changes related to medical history, telephone number/s, address, employer, or insurance information as they occur.        

Copy of Records, Radiographs, or 3D Scans

All copies of records, radiographs, and 3D scans are subject to a $35 administration fee upon receiving a signed records request.                                                        

We sincerely appreciate your understanding of the Office Guidelines!

**Fee for the 3D scan is subject to change without notice, and you will be notified of the current Fee before proceeding with any 3D scan

Please call if you have any questions.  503-385-8821