Patient information

Let's get your smile on

New Patients

When you arrive at River city Dental you will be promptly checked in and provided with the forms required for new patients. If the forms are already completed you’ll soon be seen by one of our assistants. For most new patients we begin with an exam where we review your oral health and take x-rays or scans. From there we will be able to determine a treatment plan and schedule a cleaning and any other work needed for you best smile.

Patient Forms

We use this form to collect your personal information and insurance information if applicable. If the patient is under 18, the child form will need to be completed by a parent or guardian.

Adult Patient Information Form
Child Patient Information Form

This form provides us with information regarding your preferred insurance and gives us permission to work with your insurance provider.

Financial Information Form

This form is used to get an understanding of your past medical history, allergies and current medications so we can best treat you in the future. If the patient is under 18, the child form will need to be completed by a parent or guardian.

Adult Medical History Form
Child Medical History Form

This form describes how your health information  may be used and disclosed and how you can get access to this information.

Patient Privacy (HIPAA) Form

This form is to insure you are aware of any risks that might be involved with your dental work. 

General Consent Form

What to Bring

Insurance Information

Please have with you your insurance card or have it stored on a mobile device.

Paperwork

See the table above to download the patient forms or arrive early to fill them out in the office.

Current Medications

Please have with you a current list of your medications for our records.

Appointment Policies

Cancelations

Please try to provide notice of appointment changes and cancellations within 24 hours of your scheduled appointment.

Paperwork

Returning patients do not require any additional paperwork. Please make sure to inform us of any medical history changes or updates to personal information.

New patients can fill out their paperwork in the office or download the forms ahead of time.

Arrival

We ask that patients try to arrive 5-10 minutes early unless otherwise specified. 

Payments

We are committed to helping our patients afford the best dental care by offering cosmetic dentistry financing plans that spread the cost of treatment over time. Please contact our practice to learn more about our payment options and policies.

Payment options include:

  • Cash
  • Personal checks
  • Visa/Mastercard/Discover
  • Care Credit and Wells Fargo Health Advantage Program

For patients without dental insurance: If you pay cash or check at the time of service we offer 10% off. Conditions apply.

Insurance

Our staff is happy to assist you in determining whether your dentistry treatment cost will be covered by your insurance company.

We are in network with:

Aetna
Cigna
Premera Blue Cross
United Concordia
MetLife
Delta Premier

River City Dental

Come visit us!