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Request An Appointment
Send in your name, phone number and email address with
your request. Detail whatever you feel is necessary about your needs.
One of our doctors will be glad to see you for an examination and
consultation.
Please complete the
following forms before your initial appointment
Please
Download Both Forms
I. Patient Information-Medical & Dental History
II. Insurance Verification Form
In order for us to accept assignment of your dental insurance, you will
need to have this form filled out accurately and completely before your
visit. You should call your insurance company to get the required
information. Call your carrier and ask the insurance clerk for answers
to the questions on the Insurance Verification Form. They will be
pleased to assist you and it will save you much time and frustration
later.
Sincerely,
Drs. Bill Williams, David Hayward, Jeremy Smith, & Staff
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