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The Road to a Lifetime of Smiles

patient forms

Scheduling Appointments

Our Kids First Pediatric Dentistry office attempts to schedule appointments at your convenience and when  time is available. Preschool children should be seen in the morning because they are fresher and we can work more slowly with the child for their comfort. School-aged children for routine visits can be scheduled  throughout the day. Most treatment appointments will be scheduled in the morning. Our afternoon appointments are for routine visits and older children requiring minor dental treatment.

Finances

Payment for professional services is due at the time dental treatment is  provided. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible  care. Our pediatric dentist office, serving Chandler and Gilbert, accepts cash, personal checks, and major credit cards. Also, we offer payment financing through Care Credit. Please call our office to obtain more information.

Dental  Insurance

Our office is happy to file your insurance for you.  We will make every effort to assure you  receive maximum benefits.  However, your insurance may not cover our fees completely.

Most insurance companies are required to pay each claim within 30-45  days of receipt.  We file all insurance claims electronically so that your insurance company will receive each claim within days of  treatment.  You are responsible for any balance on your account after 30 days, whether the insurance has paid or not.  We will gladly refund any credit balance once your insurance has paid.

Dental insurance is a contract between you, your employer, and the  insurance company.  We are not a party to that contract.  Dental insurance is not meant to cover all fees.  It is meant to be an aid to  your investment in your child's dental healthcare.  Most plans cover about 40-50% of average fees.  Some plans pay more, some less.

Usual, Customary, or Reasonable Fees (UCR) is a term used by insurance carriers, which is an amount the insurance company chooses to pay for each procedure.  It is not based on the average charge of practicing  specialists in the area.  It is merely an allowable amount they will reimburse.

Please do not hesitate to ask about our financial policy.  We want you to be comfortable in dealing with these matters.  If you have any questions regarding your insurance, we ask that you contact your company regarding specifics and details of your plan.

Office Policies

OFFICE POLICIES FORM

INFORMED CONSENT FORM

MEDICAL HISTORY FORM

MEDICAL HISTORY UPDATE (Recall appointments only)

If you’re a patient of our pediatric dental office which serves Chandler and Gilbert, as well as the  surrounding area, please use these forms for your convenience.

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480-802-2200
3200 S. Gilbert Road, Suite 1
Chandler, AZ  85286

Tyler Carter, DDS
Randy Weinshel, DDS
Diplomates, American Board of Pediatric Dentistry

                                                                                         Dental Care for infants, children, teenagers, and patients with special needs.
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