Forms & Finances

Patient Form Downloads

Fort Worth Dental has posted all of our new-patient paperwork online in order to make it conveniently accessible. In a matter of minutes, you can easily download the forms and complete them at home. By bringing in the completed forms to your first appointment, your first visit will be smooth and simple at the front desk. Please contact our office if you encounter any difficulty while downloading the forms. One of our friendly and knowledgeable staff members will gladly provide assistance with the forms.

New Patient Health Form

For post operative instructions, click to download the form below.

LANAP Post Operative Instructions
Patient Information

Financial Policies

Payment Options & Location

Ability to pay is of deep concern to many dental patients. We share your concern and are prepared to offer you a number of payment options.

  • If you have dental insurance, we file claims as a courtesy for our patients.
  • A 10% accounting adjustment is allowed when treatment is paid in full by cash or check on the day that treatment is presented.
  • We accept most major credit cards, including Visa, MasterCard, American Express, Discover and Care Credit.

CareCredit

We are pleased to offer CareCredit to our patients. CareCredit is a convenient, no initial payment, low monthly payment plan for dental treatments of $1,000 to $25,000.

For more information about CareCredit, please click below for more information:

carecr

 

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True No-Interest Plan

Our practice is pleased to present flexible payment plans through Lending Club Patient Solutions. Lending Club Patient Solutions offers:

  • Plans with low fixed rates & low monthly payments that never change over the life of the loan
  • Patient-friendly, True No-Interest Plans with no retroactive interest
  • No upfront payments
  • No prepayment penalty

It’s easy to calculate your potential monthly payments. Simply complete a short application which displays fixed rates and monthly payments available for Extended Plans, all without impacting your credit score.

For more information, simply ask a team member or visit lendingclub.com/patients.

Check Your Rate

Payment Calculator

We accept:

  • Most insurances accepted
  • Care Credit – Interest free payment plans
  • 7% discount if payment is received before treatment when you pay by cash or check