Please check every box on this form, even if the answer is “N/A” (not applicable). This information will be kept in the strictest confidence.
You also should know that changes in other parts of your body may affect the oral cavity and what dental treatment can be done, even if they seem unconnected. Cardiac (heart) problems, artificial joints and diabetes are just some examples.
Fill Out Our NC Patient Forms for Your Best Dental Health
At Carolina Dental Arts, we are concerned for not only our patients’ smiles, but your overall health, too. Providing us your medical history and other patient forms in our offices throughout North Carolina helps us best serve you and meet your dental health needs.
The following patient forms are for you to fill out the first time you visit our office. You can fill them out upon arrival, but we recommend printing and filling them out prior to your appointment so that we can attend to your dental medical needs more quickly.
- Patient Information
- Medical History
- Financial Policy
- Credit Card Authorization
If you have questions about our NC new patient forms, feel free to reach out to the dental office location where your appointment is scheduled.
Payment Options for our NC Dentists
Payment is expected at the time services are performed. When more extensive dental care is necessary, financial arrangements can be made with our dental offices. For the convenience of our patients, Carolina Dental Arts accepts the following payment options in NC:
- Money orders
- Care credit
- Major credit cards
Accepted Dental Insurance at Carolina Dental Arts
In order to keep our dental services as affordable as possible for our patients, Carolina Dental Arts accepts most NC dental insurance plans, including non-managed care, indemnity (traditional) and PPO out-of-network. We are not part of any managed care network.
While our accounting staff will prepare the necessary forms for your dental benefits, please note that your specific policy is an agreement between you and your insurance company. You are responsible for your total obligation, should your insurance benefits result in less coverage than anticipated. If you would like a pre-treatment estimate, our staff will gladly submit one for you.
Fees charged for dental services provided to those who are insured are the usual and customary fees charged to all our patients for similar services. Your policy may base allowances on a fixed fee schedule, which may or may not match our usual fees. Please be aware that different insurance companies vary greatly in types of coverage available, and some take care of claims promptly while others delay payment for several months.
Have questions about payment options or dental insurances we accept at our dental offices across NC? Don’t hesitate to contact us — we will gladly assist you.
View Carolina Dental Arts’ patient forms before visiting us at our dental office locations in North Carolina, including Raleigh, South Park in Charlotte, Blakeney in Charlotte, Glenwood South, Raleigh, NC, Goldsboro, and Greensboro.