© 2018 Dental Expressions. Website by SnapRoot Marketing

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Patient Registration

Health History

HIPAA/Consent 

 

Please complete all the forms at your convenience and bring them with you to your first visit.

If you opt to fill out the forms in our office, please arrive 15 minutes prior to your appointment time to complete the paperwork.

We look forward to meeting you!

 

DENTAL PATIENT FORMS

When you come into Dental Expressions for the first time, we ask you to provide us with a thorough medical and personal dental history, including any medications you may be taking, major illnesses or medical traumas you may have endured, any history of major illnesses in your family, etc.

Your dental history, especially, combined with your first thorough dental exam with Dr. Dori, helps gets us started on customizing your dental care and the dental services we will provide.

For your convenience we have supplied the following forms in a PDF format:

 
 

PAYMENTS / FINANCING FOR DENTAL SERVICES

Another Way We Make Life More Convenient for You at Dental Expressions Is Our Variety of Dental Payment Options – Cash, Check, VISA, MasterCard, Discover, Amex and CareCredit Dental Financing.

Dental treatment is an excellent investment in an your medical and psychological well-being. It’s not always inexpensive, though, but financial considerations should not be an obstacle to obtaining important dental services.

We’re sensitive to the fact that people have different needs in fulfilling their financial obligations.

CareCredit Dental Financing

CareCredit is the nation’s leading patient payment program, and enables you to finance 100% of your dental care with no money down, no interest, no up-front costs, no pre-pay penalties, and no annual fees.

CareCredit offers a comprehensive range of plan options for treatment fees and it only takes a few minutes to apply. CareCredit can be used by your entire family for ongoing treatment, without having to re-apply.

More information about CareCredit and the various options and restrictions that may apply to your situation, is available on their website.

Payment for dental services is due at the time they are provided. Please ask about 5% payment discounts. 

CONTACT US

Our Address

36 Endicott Street East

Alpenrose Resort Plaza 

Laconia, NH 03247

info@dentalexpressionsnh.com \ Tel: 603-366-4400 

  Our Hours

Monday 7:00 am – 4:00 pm
Tuesday 7:00 am – 5:00 pm
Wed & Thur 7:00 am – 4:00 pm
Friday appointments by request