Forms
Financial Information
Post-Operative Care
Sterilization Protocol

Disclaimer

Patient Forms & Information

Forms
Patient Registration and Medical History     
The form is in Adobe Acrobat Format (pdf), available free from Adobe. Please print the form on your printer, fill it out (please print clearly), and bring it with you on your first visit.

Financial Information
We appreciate the investment of both time and money required to proceed with comprehensive dentistry. After your examination, the doctor will review your treatment plan with you and will provide a description of the proposed treatment. Before any treatment is started we will discuss several payment options for your convenience.

We accept Visa, Mastercard, Discover, American Express and debit cards.

We will also gladly submit any appropriate insurance forms for treatment done. Depending upon the type of insurance, the reimbursement either is sent to our office or to the patient.

Sterilization Protocol
To insure your safety, all procedures at our office exceed even the most stringent guidelines established by the Center for Disease Control (CDC) and the Occupational Safety and Health Agency (OSHA).

• All instruments and handpieces are steam autoclaved after every use and disposable items are utilized wherever appropriate.
• Patients and staff wear protective safety glasses during treatment.
• Disposable gloves are worn while treating patients and are never used on more than one patient.
• Staff members wear masks during the procedures to protect our patients.
• All areas that are touched during the procedures are covered with a plastic wrap and changed after each patient so as to eliminate the potential of cross contamination.
• All surfaces, chairs, lights and units are thoroughly disinfected before and after every patient use.
• Weekly spore checking is done to insure that our steam autoclave properly destroys all germs.

Newtown Dental Care 7 Cambridge Lane Newtown PA 18940
Phone 215.968.7787