Inwood Dental PC

implant + Braces Center

Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Registration Form

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Financial agreement

Our goal is to provide the highest quality of dental care possible and to have clear communication of our financial policy. 

ALL ACCOUNTS ARE DUE AND PAYABLE AT THE TIME OF SERVICE.  If a procedure requires multiple appointments, payment is required at the first appointment. 

Payment Options:

1.       Cash

2.       Check (There is a $30 processing charge for non-sufficient funds or returned checks.)

3.       Mastercard

4.       Visa

5.       Novus/Discover

6.       Credit card authorization for recurring charges: a.      Treatment exceeds $200, b.      Plan may      not exceed 4 months

Parents not accompanying their child to an appointment must make PRIOR arrangements for payment (cash, check or credit card information)

Parents accompanying their children are financially responsible for payment.

Patient with Insurance: The PATIENT is responsible for the ESTIMATED non-covered portion, procedures and/or deductibles at the time of the service.  OR the patient can sign a credit card authorization to bill their credit card before insurance has paid for the visit.  If the insurance company does not pay after  8 weeks, we will bill you for the balance.

WE do not offer in-office financing

the following options below maybe used for your financial needs, Carecredit or lending Club

american express

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