Acworth GA Dentist, Acworth Family Dentist, Dentist 30101

PATIENT FORMS

We have provided the forms below as a convenience to save you time when you arrive for your appointment. Clink on the form below to download your registration and medical forms. Please complete and sign them before your visit.

Patient Form

Dental History

Medical History

FINANCIAL POLICY

Insurance Companies our office is contracted with:

Blue Cross Blue Shield (*We are only contracted with some BCBS plans~please call your representative to determine if we are contracted with your plan)

Cigna PPO

Delta Dental (*Premier Plan only)
Guardian

MetLife PDP

Tricare

Our payment methods are as follows:

Cash
Check
Visa
Mastercard
American Express
Discover
CareCredit (CareCredit is a credit card for dental services that offers 12 months of interest free financing. You may learn more about this @ carecredit.com.)

Please view our privacy policy here.

Your family deserves the BEST! Dr. Wilson can perform many traditional dental procedures with Waterlase. Waterlase is a revolutionary dental tool that uses a combination of laser energy and water. This means that you may be able to avoid receiving an injection and experience numbness after your appointment. Ask our office today about this minimally invasive dentistry.

Would you like a BRIGHTER and WHITER smile??? If so "like" our Facebook page to be entered into a drawing for a free teeth whitening. This will include bleaching trays and your choice of day white or night white. Good Luck!!!