For Our Patients
New Patient Form
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 email@example.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.
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.
- United Concordia – Advantage Plus Program
- Cigna – PPO Plan
- Delta Dental – PPO Plan
- Aetna – PPO Plan