For Our Patients

New Patient Form

Click to Download

For your convenience, we have supplied a pdf form that can be filled out in your own home. Please download this form and click submit or save and email to tcdkaren@yahoo.com. You can also print and bring them to your first appointment.

Click here if you would like to fill out and submit your form online.

We look forward to meeting you for an excellent first visit.

Child Health History Form

Click to Download

For your convenience, we have supplied a pdf form that can be filled out in your own home. Please download this form and click submit or save and email to tcdkaren@yahoo.com. You can also print and bring them to your first appointment. We look forward to meeting you for an excellent first visit.

 

No Insurance? No Problem.

We have created a new Oral Health Savings Plan for patients without dental health coverage. Please download our pamphlet, fill out the attached form and bring to our office on your next visit.

Learn more about Our Oral Health Savings Plan Here!

 

Financial Options and Arrangements

We offer the following payment options:

  • VISA, MasterCard, Discover, American Express
  • Check, Cash, or Money Order
  • CareCredit Monthly Payment Plan – CareCredit is a monthly payment program that allows patients to get the healthy, radiant smile they’ve always wanted with no up-front costs, no pre-payment penalties and LOW monthly payment plans. CareCredit can be used for any dental procedure, including cosmetic, restorative, basic care, and sedation. For more information, please visit CareCredit.com.

Briglia Dental Group will always work with your dental health insurance provider to maximize your coverage and reimbursements.

 

Insurances Accepted

  • United Concordia – Advantage Plus Program
  • Cigna – PPO Plan
  • Delta Dental – PPO Plan
  • Aetna – PPO Plan

 

Testimonials

The staff as well as Dr. Briglia made me feel comfortable and relaxed I went to Dr. Briglia for a chipped tooth and he did an amazing job fixing it…

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