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Our philosophy of care is centered on ensuring that your needs as the patient come first. For your convenience, you may download and complete our Registration, Health History, and HIPAA forms and bring them with you to your first appointment. Please download the forms first (by clicking right mouse button and choosing "Save Link/Target As" function) before filling out the information. Please print and bring them with you.
Since we are a specialty (i.e., referral based) office please do not forget to provide us with any Referral Form from your doctor and/or any relevant x-ray for us to review.
PLEASE NOTE: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit.
FINANCIAL
POLICY
At Pleasant Hill Oral Surgery we make every effort to provide you with premium care and convenient financial options (i.e. cash, debit card, credit cards). We are a completely "fee-for-service" practice. This means we are an "out of network" provider for your insurance company. Patients with dental insurance PPO plans are welcome and we will help process your insurance claim(s) as a courtesy to you.
There is a fee for consultation and any x-ray we may need to obtain. Full payment is required at the time of service. To learn more, please call our office for more information.
Our office also offers financing through CareCredit.
PRIVACY
POLICY
We take protection and confidentiality of your personal health information seriously. Please review our Notice of Privacy Practices for details.