New Patient Registration Form:

If you would like to complete your registration forms before you arrive, you may download them by clicking below. The new patient forms are in PDF format. If you do not have Acrobat Reader, get a free copy by clicking on the link below. Print out both pages, fill them out, and bring them with you on your first visit. Also, after reading the Notice of Privacy Practices, print the Acknowledgement form below, sign it, and bring it in, too.

New Patient Form (page 1) (Acrobat PDF form)

New Patient Form (page 2) (Acrobat PDF form)

Acknowledgement of Receipt of Notice of Privacy Practices (web page)

Insurance:

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.

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.

Payment:

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:

If you have any questions about your insurance plan or payment options, please call Our staff at (516) 783-2900 or
e-mail us at info@nowdental.com.

Back to Top