Consent Forms
- Consent for General Oral Surgery and Tooth Extraction (For limited procedures not otherwise listed)
- Consent for Conventional Periodontal Surgery
- Consent for Laser Periodontal Surgery
- Consent for Crown Lengthening Surgery
- Consent for Gingival Augmentation Surgery
- Consent for Alveolar Ridge Augmentation Surgery (Bone grafting)
- Consent for Frenectomy Surgery
- Consent for Dental Implant Placement Surgery
- Consent for Maxillary Sinus Elevation Surgery
- Consent for Tissue and Bone Regenerative Materials
- Consent for Scaling and Root Planing with Diode Laser Debridement
- Consent for Nitrous Oxide Sedation
- Consent for Minimal Oral Sedation/Anxiolysis Therapy
- Sedation Questionnaire
- Consent for Patients Who Have Received Bisphosphonate Drugs
- Shared Decision Making Tool for Artificial Joint Prophylaxis
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PAYMENT OPTIONS
To enable greater access to care, we offer our patients a cash payment discount incentive and options for outside financing. Summit View Periodontics accepts most major credit cards. We can offer immediate financing options for your care through companies such as CareCredit and Wells Fargo Health Advantage.
INSURANCES
Summit View Periodontics accepts most major Preferred Provider Organization (PPO) insurances and indemnity programs. We will aid you in coordinating therapy with your insurance carrier. Every attempt to ensure accuracy is made. Knowledge of each patient’s particular dental insurance program and payment for services rendered is ultimately the responsibility of the patient. Please contact our office for a current list of accepted programs.
The associated fees for your treatment will be provided at the end of your preliminary examination. Due to the complex nature of certain treatment needs and timing of your care, these fees can vary. Our schedule of fees will be reassessed semiannually. Your existing treatment plan is guaranteed not to change for ninety days from the day of creation.