BEFORE THE FIRST VISIT
May we make the following suggestions to make your child’s first visit to Asheville Pediatric Dentistry a great one?
- Tell your child that the dentist will be gentle and friendly and will count their teeth.
- Please do not tell your child that the dentist will not hurt, as this may never have entered their mind. Please do not use words such as needle, shots, drill or other words suggesting unpleasantness.
- Expect your child to do well and enjoy the first visit to our office and chances are they will!
The initial appointment is reserved specifically for your child. Any change in this appointment affects many patients. If a cancellation is unavoidable, please call the office at least 24 hours in advance so that we may give that time to another patient.
Please complete the New Patient Health History form and bring it with you to the first appointment. Please review the New Patient Paperwork forms; these will be signed electronically at the office.
REQUIRED NEW PATIENT DOCUMENTS
New Patient Health History (PLEASE PRINT)
Consent Forms (READ ONLY)
Optionally download this form if you need to update your existing Health History on file:
Health History Update
THE FIRST VISIT
We will review the Health History Form with you at the first visit. At that time, you and your child will be introduced to our dental team.
Parents are welcome to accompany their child during their visit. This gives you an opportunity to see us working with your child and allows the dentist to discuss dental findings and treatment needs directly with you. Siblings are encouraged to remain in the reception room.
One of our doctors will perform a head and neck examination and evaluate the health of the teeth and gums. Radiographs (x-rays) are taken only as our doctors feel they are necessary. If no treatment is needed, the teeth will be cleaned and fluoride applied to the teeth. Additional services will be scheduled for a later visit.
Please contact our office if you have questions regarding payment or dental insurance.
The scheduled appointment is reserved specifically for your child. Any change in this appointment affects many patients. If a cancellation is unavoidable, please call the office at least 24 hours in advance so that we may give that time to another patient.
- For young children, restorative (fillings, extractions, etc.) procedures are scheduled in the morning. Children, as well as adults, are more prepared and do better in the morning for these types of procedures.
- We strive to see all patients on time for their scheduled appointment. There are times when our schedule is delayed in order to accommodate an injured child or an emergency. Please accept our apology in advance should this occur during your appointment. We will do the exact same if your child is in need of emergency treatment.
- Please plan to arrive 5 minutes or more before your scheduled appointment. This will allow time to complete any additional paperwork and see your child on time.
- If you arrive 10-15 minutes late for your appointment, you may be asked to reschedule for the next available appointment time.
- Again, please call at least 24 hours in advance if a cancellation is unavoidable so that we may give it to another patient.
- Broken or missed appointments affect many people. If two (2) broken/missed appointments occur or two (2) cancellations without 24-hour notice, our office reserves the right to not schedule any subsequent appointments.
- A parent or legal guardian (with official documentation) must be present during the initial examination and any restorative appointments.
If at any time you have questions, please feel free to ask our staff or call our office. We are here to help in any way we can. We appreciate you entrusting your child's dental health to us!
Please familiarize yourself with the following information. If you have any questions, please feel free to ask one of our business office staff.
- Please be aware that the parent bringing the child to our office is legally responsible for payment of all charges. We cannot send statements to other persons.
- We accept cash, personal checks, MasterCard or VISA. We are also a participating CareCredit provider.
- Payment: For the convenience of our patients with dental insurance, your estimated patient portion will be collected at the time of service. We will do our best to provide accurate estimates for co-pays, but please understand that our estimated benefits are not a guarantee of payment from the insurance company and may vary from actual payment received. We will send in all insurance claims and the insurance will send their payments directly to our practice. You will be billed for any balance after the insurance plan pays on the claim. You will have 30 days once you receive a statement from our office to remit any remaining balance. For our self-pay patients, payment is expected in full for each appointment as services are rendered.
- Emergency Treatment - all emergency treatment must be paid in full at the time the service is rendered.
- Dental Insurance - there is no direct relationship between our office and your insurance company. The type of plan chosen by you and/or your employer determines your insurance benefits. As such, we have no say in the selection of your insurance company, no control over the terms of your contract, the methods of reimbursement or the determination of your insurance benefits.
- Pre-treatment Authorization: Some insurance companies recommend an estimate of the work to be done and the fees to be charged before determining their benefits to you. If so, we will provide you with the pre-treatment fee estimate. In this case, it will be up to you to determine if you wish to proceed with treatment before the insurance benefit is determined.
- Appliances: The cost of the appliance must be paid on the day your child's impressions are taken. This is necessary because our office must pay the lab bills when appliances are ordered, not when they are completed.
- We recognize that under unusual circumstances an account balance may be incurred. Asheville Pediatric Dentistry requires that all outstanding balances be paid in full within thirty (30) days unless other arrangements have been made. Also note, if we have not received payment or you have not contacted us within thirty (30) days, further action may be taken with a collection agency or with Small Claims Court. We reserve the right to apply an interest rate of eighteen percent (18%) APR from the date of service. Thank you in advance for your understanding!
Your understanding and cooperation are greatly appreciated! You are helping to keep our overhead expenses down and your fees as low as possible.
PATIENT SAFETY AND PRIVACY
One adult is welcome but not required to accompany your child to the treatment area. We encourage self independence to help promote the growth and development of your child. For safety and privacy of our patients, all others, including children that are not scheduled at this appointment, are asked to remain in the reception room. Young children in the reception room will need a supervisory adult. Also, please refrain from bringing strollers into the treatment area, as they tend to block common pathways.
The use of cellular phones is prohibited in the treatment area. The extra conversation carried on by others can be most distracting to children, preventing us from close, careful communication with each young patient. Thank you for your understanding and cooperation. This will help us to serve your child better.