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New Patient Information

You may preregister with our office by filling out our online Patient Registration Form. On your first visit to our office, we will ask you to sign your completed form electronically. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Patient Registration  (Opens in a secure window)

Our Philosophy

Our purpose is to provide the highest quality of periodontal and implant care for our patients. Only through excellence in dentistry and caring for others can we make a positive contribution to the oral health, happiness and self-esteem of our patients.

Although no one really likes to go to the doctor or dentist, we strive to make your visits with us as comfortable and as pleasant as possible. We strongly believe that our patients' comfort is an important part of quality dental care. Our mission is to treat every patient as if they are our only patient.

Our goal is to make you feel comfortable and relaxed. We are here to listen to your questions and concerns and to help provide solutions leading to your better health. Please don't hesitate to e-mail us if you have any questions regarding your care, or call us at 1 (800) 548-3719 or (256) 883-4032.

Patient Forms

For your convenience, we have provided our patient registration forms and policies for download. Please download and complete the new patient forms and bring them with you for your initial visit.

Dental History Form
Dental Insurance Information
Patient Authorization
Patient Information Form
Fax Referral Form

Initial Visit

Your initial visit with us will include a review of your medical and dental history, a complete examination of your mouth, and a treatment conference. After a treatment plan has been presented to you, we will notify your family dentist of the findings and recommendations. Please bring any medical and/or dental insurance cards with you.

IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the initial visit.

Insurance Information

As a courtesy to our patients, our front desk staff will process and submit the claim forms and all pertinent documentation for all dental insurance companies. We do not participate with any dental insurance company and are considered “out of network”. Payment is expected at the time of service.

We ask that you bring your insurance card to your first appointment so that we can make a copy for our records. We also ask that you keep us informed of any changes to your insurance so that your claims are filed and submitted correctly, and to keep your patient file current and up to date.

Most insurance companies will respond to a claim filed within four to six weeks. Please call your insurance company if you have not received payment or an explanation of benefits within that time frame. Our front desk staff will be happy to re-file the claim for you if your insurance company requires more information in order to process benefits, or in the event it has been somehow misplaced in their files.

Please keep in mind that your policy is an agreement between you and your insurance company, and that you are responsible for your total balance should your insurance benefits pay out less than anticipated. Any estimate or pre-determination of benefits is not a guarantee of payment. Your policy may also base its allowance on a fixed fee schedule, which may or may not coincide with our fees. You should also be aware that there are all different types of insurance plans and policies, and they all vary greatly in the types of coverage they provide.

Financial Information

We deliver the finest care at the most reasonable cost to our patients, therefore payment is expected at the time of service unless other arrangements have been made prior to your scheduled appointment. For your convenience we accept cash, checks, and most major credit cards:

Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage. If you need further assistance, take a look at CareCredit: CareCredit is different from a regular credit card. It helps you pay for out-of-pocket expenses not covered by medical insurance by extending special financing options that you can't get when using your Visa or MasterCard.

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At North Alabama Periodontics, we are committed to providing quality healthcare to patients of all ages. We provide individualized solutions for your unique dental health needs. Contact Us
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