Forms/Financial

Patient Forms

DDS Maryville Patient Forms

We understand how busy you are and this is why we now make our new patients forms available online, providing you with the option of completing them at your leisure in the comfort of your own home. Simply print them out, fill in your information, and bring them in during your first visit to our Maryville DDS. If you choose to complete the forms at our office before your appointment, please arrive a few minutes early to allow yourself time to complete them without feeling rushed.

 

Click here to open all the forms in one document or choose from the list below:

Welcome Letter (pdf)

Patient Information (pdf)

Medical and Dental History (pdf)

Smile Evaluation and Photographic Consent (pdf)

HIPPA Privacy (pdf)

One-time Authorization (pdf)

FREE Initial Consultation! (pdf)

 

 

Financial Information

Financial planning for what can be a substantial purchase is important and we would like you to be well informed about the cost and payment options that are available to you. Our team has put together some helpful information to assist in deciding which form of payment will work best for you and your individual needs. Whether you have been saving for a while, plan on using a low interest credit card or just need some direction in choosing the finance company that will fit your situation, we are here to help. We accept:

  • Cash
  • Check
  • Credit Card (VISA and Mastercard)
  • Debit Card

Providing services by a DDS to Maryville, Alcoa and Knoxville, TN.