First things first, welcome! We are happy you have entrusted us with your oral health. It’s a responsibility we do not take lightly. We’re confident you’ll have a wonderful experience with our helpful and friendly staff. To assist you in the process, we’ve outlined a few things to expect at your first appointment and a reminder on other items to bring with you. If at any time you have questions on any of the items below, please call or email our office and we will get you the answers you need.
New Patient Forms
Please complete and bring the below forms with you to your first appointment. This will ensure that you’re seen in a timely and efficient manner.
- Patient Registration Form
- Medical History Form
- HIPPA Authorization Form
- Consent Form
- Bluemound Medical Center Questionnaire
Please read and review the HIPPA Policy.
What to bring to your appointment
- Completed New Patient Forms
- Insurance cards
- Valid driver’s license.
If you’ve had X-rays taken in the last year, please have your last dental practice email them to firstname.lastname@example.org before scheduling your appointment. Our email is secure and HIPPA compliant.
If you’ve not had any x-rays taken in the past year, we will take them with our digital x-ray systems. Digital x-rays allow us to quickly capture the views of your teeth quickly and efficiently. No development is required and we are able to view them on our computers instantly.
If more than a year since your last x-rays, digital photos of your teeth, mouth and smile will be taken. Afterwards, a thorough and comprehensive exam will be completed. This data is gathered to develop a treatment plan tailored to your specific needs. We will also listen to and address any of your concerns.
At this time we accept:
- Delta Dental
- United Health Care
- Care Credit
- Master Card
- Cash or check
All payments are due at the time of service. Payment plans are available through Care Credit.
Schmidt Dentistry and Hygiene provides:
- complementary Insurance submission
- Electronic Filing of claims
- Complementary estimation of eligibility and benefits.
So we may answer any questions or concerns, please contact us during regular business hours.