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Patient Information

Patient Forms

We are delighted that you have chosen the offices of Doctors Birdwell and Guffey for your dental care. Since your time is valuable to us, we are happy to make our new patient forms available online. Simply print the forms, fill them out, and bring them with you to your first visit. Include a list of your current medications and, if you have dental insurance be sure to bring your card.

In addition, please let us know if your physician requires that you pre-medicate with antibiotics before dental cleaning. (Antibiotic pre-medication is required for persons with certain specific heart conditions and prosthetic major joints such as knees and hips.)

Please arrive with your completed forms fifteen minutes before your scheduled appointment time to allow us time to process your information.

We look forward to meeting you!

Patient Forms PDF Packet
– HIPAA Consent Form
– 2016 Financial Policy

Financial Information

We don’t want anything to stand in the way of your oral health, including financing.
We are proud to accept a variety of payment methods including cash, checks, and credit cards (Mastercard, Visa, American Express and Discover.)

If you prefer to make monthly payments, we can help you create an account with Care Credit. Care Credit specializes in financing health care and they offer both short term and long term financing for medical, dental and veterinary care. Many patients qualify for no interest plans.

As a courtesy to our patients, we will gladly file your insurance. We are a Delta Dental Preferred provider and we can file insurance claims to most insurance companies with the exception of Tenncare and Medicare. For most insurance plans, we can offer you an accurate estimate of your insurance benefits for a particular procedure or for an entire treatment plan. We can also file pretreatment estimates for a more accurate picture of your insurance coverage.

Please be advised that dental insurance is like other forms of insurance in that it is complicated. The patient will be responsible for co-pays, deductibles and any portion that the insurance does not cover.

While health care costs and wages have risen over the last three decades, dental insurance benefits have remained at around $1000 per year for the last 30 years. Accordingly, insurance plans do not cover as much as they did in 1980. While we will help you make the most of your insurance, dental insurance now should be considered an aid to payment of dental treatment rather than comprehensive coverage.