PREPARE FOR YOUR VISIT

To make your visit move along a little faster at check-in, please fill out the forms below, print and bring them in with you when you come for your visit. Thanks!


As of 5/1/2020, please also fill out the TWO COVID-19 questionnaires prior to coming in for your appointment.  

BRING THE FOLLOWING:

VALID PHOTO ID

NEW PATIENT FORMS

INSURANCE CARDS

image16

Please bring a valid photo ID.  If the patient is a minor, we will need the photo ID of the legal guardian that is accompanying the minor for their visit.

INSURANCE CARDS

NEW PATIENT FORMS

INSURANCE CARDS

image17

Please bring your current dental and medical insurance cards.  At this time we are only contracted with dental insurances, but we ask you to bring both.

NEW PATIENT FORMS

NEW PATIENT FORMS

NEW PATIENT FORMS

image18

Fill out the new patient paperwork ahead of time if you can, and bring it in with you to your appointment.  This definitely helps speed up your check-in process!

HAVE YOUR REFERRING PROVIDER SEND

REFERRAL

MOST RECENT PANORAMIC X-RAY

MOST RECENT PANORAMIC X-RAY

image19

Your referring provider can send the referral to us by fax at (470)745-0659 or email to us at contactus@naoms.net.  You can also bring it with you to your appointment.

MOST RECENT PANORAMIC X-RAY

MOST RECENT PANORAMIC X-RAY

MOST RECENT PANORAMIC X-RAY

PANORAMIC X-RAY, ORAL SURGEON

If the patient has had a panoramic x-ray in the past 6 months, have it sent faxed to us at (470)745-0659 or email to contactus@naoms.net.  You can also bring a print out or digital copy to your appointment..  If we do not receive this by the time of the appointment we will need to take one.  **Typically insurances have frequency clauses on how often they will cover these so it can fall to patient responsibility.