Washington D.C. Cosmetic Dentist – Dr. Ingber – Patient Forms
Here at Ingber Dental we strive to make your dental visit as easy and trouble-free as possible. Dr. Ingber and his staff understand that your time is valuable and have therefore provided several patient forms that you can review, print and fill out at your convenience prior to your first visit to our leading Washington D.C. cosmetic dentistry office.
Please review the following patient forms, fill them out and bring them to your first dental visit.
- Welcome to Our Dental Practice
Here you will find useful information regarding your treatment options, our office hours, fees and other important topics pertaining to our practice and your dental treatment. After you have reviewed the information, please sign and date the last page.
- Notice of Privacy Form
As our patient, you are entitled to maximum privacy. This form describes situations in which your treatment information may be disclosed to others upon your consent, such as family and friends. Please be sure you understand this information completely prior to signing the bottom portion.
- Consent Form
By signing the consent form you authorize our staff members to administer treatment as well as contact your insurance carrier for payment. Please review the information carefully and return the signed form.
- Hippa and Medical History Form
The information that you provide on this form is essential to your dental health and treatment. Please fill out each section to the best of your knowledge. You will be asked to provide this information upon your first visit.
- Dental Insurance Information Form
Please fill out the upper portion of this form even if you dont have dental insurance.
- Records Request
By completing this form, you are allowing us to request copies of your dental records from another healthcare provider. This helps us provide you with thorough dental care.
If you have any questions regarding the patient forms or need assistance, please contact our office at (202) 331-7474. Our staff will also be more than happy to address all of your questions at the time of your visit.
Dr. Ingber and his associates are known as leading Washington D.C. dental implants providers who have helped many patients obtain a restored and naturally beautiful smile through a range of sophisticated procedures, including dental crowns and porcelain veneers. Dr. Ingber and his team also offer in-office teeth whitening treatments and are trusted D.C. dental bridge providers who patients visit for all their dental needs.