New Patient Forms and information

First Visit

Your initial appointment will consist of an examination and explanation of your diagnosis and treatment options by Dr. Gilchrist.  A preventative cleaning and x-rays will usually be done the same day.  Complex medical histories or treatment plans may require an evaluation and a second appointment to discuss treatment options on another day.

Please assist us by providing the following information at the time of your consultation:

  • Previous dental records and any X-rays.
  • A list of medications you are presently taking.
  • If you have medical or dental insurance, bring the necessary information.  Also bring your completed registration forms.

*IMPORTANT: A parent or guardian must accompany all patients under 18 at the initial visit.

Patient Registration Forms

Please take the time to review and complete the following forms prior to your first appointment at our office.  This will allow us the opportunity to complete your registration in a timely manner.  After you complete these forms, they will be scanned into your chart electronically.  The forms will be returned to you at your request, or they will be shredded.  We recommend that you keep them for your records.

Patient Information

HIPAA Form

Office Policy

Photographic Release Form

General Dentistry Informed Consent Form

Insurance/Billing

Our office accepts most dental insurance.  We file insurance claims as a courtesy to you.  Unless prior arrangements have been made, your estimated portion, factoring insurance, is due when services are rendered.  Please call if you have any questions or concerns regarding your initial visit.

We make every effort to give you an accurate estimate of your insurance coverage, but ultimately, it is your responsibility to know your coverage limits.  However, please be aware that some, or perhaps all, of the services provided may be considered non-covered services and not considered reasonable and necessary under your dental insurance coverage.  You are responsible for any non-covered service.

For your convenience we accept check, American Express, Visa, MasterCard and Discover.  We also offer CareCredit, which is an outstanding option for financing your dental treatment at 0% interest for up to 12 months.