Patient Forms

On the day of you first appointment, please arrive 15 minutes early to fill out paperwork and ensure the staff has enough time to set you up. Typical forms you will be required to fill out include a patient's medical history form, patient information form, financial agreement, a notice of privacy practices and consent form, and any other information the office needs before they can begin treatment. Have your driver's license and insurance card ready when you check in at the reception desk.

 

To speed up the new patient registration process, you may also fill the forms out online by using the button below.

Patient Registration Forms  <https://gsd.identalcloud.com/GoldenStateDentistry/Patient/_practice/1/Registration>

 

 

Financing Options

To make it easier for you to start your treatment plan right away, we are pleased to offer our patients Sunbit payment plans. Instead of paying the full dental treatment cost upfront, Sunbit lets you pay for your treatment overtime with affordable monthly payments.

 

See how much you are eligible for without impacting your credit.

See Your Sunbit Monthly Payment Options  <https://apply.sunbit.com/goldenstatedentistry>

 

Sunbit-Financing-Payment-Plan

 

In addition, we offer CareCredit, a healthcare credit card that helps patients to take care of their dental services when they need or want to, instead of having to wait.Learn More About CareCredit  <https://www.goldenstatedentistry.com/financing-with-carecredit>

In-Network Dental Insurance

We accept all PPO insurance plans, but we are in-network with the following:

Cigna Logo - 06.17.21

Metlife Logo-1

Out-of-Network Dental Insurance

We are still accepting out-of-network PPO plans, and you can definitely receive your dental care at our office. If you decide to do so, here is how it works:

 

STEP 1. We will collect the full office fee at the time of your appointment.

STEP 2. We will submit the claim on your behalf.                                       

                           STEP 3. After the claim is filed and processed, your insurance will reimburse you directly. 

 

With some insurance plans, there really is very little difference between in and out of network benefits. However, you will need to read your specific insurance contract to determine your benefits for an out-of-network provider.

 

Please don’t hesitate to contact our office so that we can review your specific plan with you.

 

We guarantee that we establish our fees fairly and independently, based on the cost of running the office and providing the necessary care and attention to you and all of our patients.

 

 

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