Patient Form (Download below)
Thank you for choosing Hartzell General Dentistry. Before your visit, please print out and read all the information within our new patient forms. If you have any questions, please call us. Then fill out and sign the forms and bring them with you when you come for your appointment. We’re looking forward to serving you!
Click the icon below to download all new patient forms.
Insurance information
We accept payment from many different insurance companies, however we are not in network with any insurance company. We will be happy to submit your claim to your insurance company as a courtesy for you. In the case of any issues or limitations with your coverage, you will responsible for the total or remaining costs charged by our office.
Financial Responsibility
Payment for all of our dental treatments is expected at the time of service. We accept Cash, Check, Debit, Discover Card, MasterCard, Visa, American Express and CareCredit (apply below).
Please remember you are fully responsible for all costs, or remaining costs, charged by this office regardless of your insurance coverage.
Care Credit
Dental care financing has never been easier. A CareCredit credit card can help you get the dental treatments you need now, without needless delay. Use it for deductibles or to pay for treatments and procedures. Find out if you qualify today.
CLICK HERE TO PAY WITH CARE CREDIT
CLICK HERE TO VISIT CARE CREDIT WEBSITE AND APPLY FOR FINANCING
(Your credit score will not be affected)
