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Financial and Insurance:
Please read, print, sign and bring with you to your next dental appointment
Financial Policy and Responsibility Agreement
Insurance:
Dental insurance is intended to cover some, but not all of the cost of your dental care. Most plans include coinsurance provisions, a deductible, and certain other expenses which must be paid by the patient at the time the service is rendered. It is your responsibility to verify insurance coverage and assume responsibility for payment of all procedures you elect to have done.
Payment:
For that portion of costs not covered by insurance, we offer several payment options:
- Cash or Personal Check
- Credit Card - We accept Visa, MasterCard, Discover and American Express.
- We've made arrangements with a credit company that will finance your dental work with approved credit.
Contact our office for more information.
If you have any questions about your insurance plan or payment options, please call us at (636) 230-7557 or e-mail us at kmdentalarts@gmail.com.
New Patient Forms:
If you would like to complete your registration forms before you arrive,
you may download them by clicking below.
The
forms are in PDF format. If you
do not have Acrobat Reader, get a free copy by clicking on the link to the right.
Adult Dental and Medical Histories
Child Dental and Medical Histories
Financial Policy and Responsibility Agreement