New Patients

New Patients

Registration Forms

In order to make your first visit to the dental office go smoothly the patient forms can be done ahead of time. We have electronic registration forms and you are able to receive them in your E-mail when you schedule your initial appointment.  You may also choose to fill them out in our office at your scheduled appointment.


Payment is expected at time of service. If you have insurance, you will be expected to make an estimated payment for that portion not covered by your insurance plan. For that portion of costs not covered by insurance, we offer several payment options:

Cash, Money Order or Personal Check
Credit Card – We accept MasterCard, Visa and Discover and American Express.
Extended financing (sometimes without interest) is available for our patients with approved credit through Wells Fargo Health Advantage, Care Credit and Citi Health Card.



Dental insurance is intended to cover some, but not all of the cost of your dental care. Most plans include coinsurance provisions, a deductible, and certain other expenses which must be paid by the patient at the time of services. Reimbursement amounts are not, and never have been, a guideline for quality care. Our office is committed to provide each patient with optimal dental treatment to match their individual dental conditions regardless of dental insurance limitations.

We can file most insurance claims for you. Please bring your insurance plan information with you on your first visit. We will work with you to ensure that you receive the maximum benefits to which you are entitled. If you have any questions about your insurance plan or payment options, please call our staff at: 716-200-4831.

We offer a 10% Veteran and 10% Senior (65 yrs & older) discount if paying with cash or check; 5% if paying with credit card at the time of service.

Patient Information

New Patient Questionnaire