NEW PATIENT FORMS
SCHEDULE ONLINE by clicking Book Appointment!
Click on the button below for New Patient Forms you can download, print and complete before your first scheduled dentist appointment with Bondurant Family Dentistry. We look forward to meeting you!
If you’re still unsure or uneasy about scheduling your first dental appointment with us, please feel free to call us at 515.967.4002 for a no-pressure tour of our office. We’ll appreciate you coming in to meet us!
At Bondurant Family Dentistry, we’ll never offer a deeply discounted or free service to get you in the door and then recommend a high dollar treatment plan that you don’t need. We don’t resort to gimmicks, stunts, up-sells, tricks, or games, because that’s not how we’d want to be treated. We understand you have nothing to go by other than previous experiences or what others have told you. We will consistently work hard and treat you with fairness, dignity and honesty to earn your trust.
We hope to accommodate your dental care with a wide variety of options for payment. Reviewing the information below will help match you with your preferred payment method.
We accept insurance from a wide range of providers for your convenience. We’ll work to help you coordinate your care with your insurance provider. If you carry dental insurance, please check the list below for your provider:
Associated Benefits Corporation
Benefits Management Group
Blue Cross Blue Shield
Cypress Benefit Admin
Employee Benefits System
John Deere UHC
Blue Care Dental
Central States Services
Health Partners of MN
Indiana State Roofers
Kansas City Life
Lincoln Financial Group
Sun Lite Financial
UHC (Not John Deere)
At Bondurant Family Dentistry you’re able to use your major credit card to cover your expenses. We accept all major credit cards including Visa, MasterCard, American Express, and Discover.
Instead of putting off needed dental care, Care Credit is an option for those who qualify for these flexible monthly payments. With qualification, CareCredit offers no interest if paid in full in 6, 12, 18 or 24 month* with their promotional financing options. Please read and understand the CareCredit terms and financing options. CareCredit promotional financing options may expire at any time. Bondurant Family Dentistry is not affiliated with CareCredit.
Visit www.carecredit.com for more information, or click the CareCredit icon on your Mountain Dental office page to apply now.
FREQUENTLY ASKED QUESTIONS
Then you can get a head start by clicking on the ‘NEW PATIENT HEALTH HISTORY AND HIPAA’ button under ‘NEW PATIENT FORMS’ above to download, print and fill in your information before your visit.
You can walk in to get the form, we can fax or email it to you, or you can click on the ‘CONSENT TO RELEASE RECORDS’ above and download, print, fill in and then submit the form to our office in order for us to obtain your previous records.
Long-term dental anxiety can lead to oral health problems resulting from avoiding the dentist.
We can also offer to administer nitrous oxide, known as “laughing gas,” or we can prescribe other remedies to reduce your anxiety.
Gum disease is silent like diabetes and high blood pressure until it’s too late. The good news is that routine dental care can help prevent it!
We will listen to you when you share about your dental issues and will ask thoughtful questions for further assessment. Then simple or phased treatment plans are developed with your involvement. Open, honest, productive communication with our patients is our Standard of Care.