New Patient Forms

Patient Forms

Patient Information

Scheduling

We will schedule your appointment as promptly as possible. If you have pain or an emergency situation, every attempt will be made to see you that day.

We try our best to stay on schedule to minimize your waiting. Due to the nature of dentistry, various circumstances may lengthen the time allocated for a procedure. Emergency cases can also arise and cause delays and we appreciate your understanding and patience as we provide attentive care to each of our patients.

Please call with any questions or to schedule an appointment. You can also request an appointment and we’ll get in touch shortly.

Financial Policy

We accept cash, personal checks, Visa, MasterCard, Discover, American Express, Care Credit and select insurance plans.
We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance. We also provide financial assistance through Care Credit.

If you have questions regarding your account, please contact us at . Many times, a simple telephone call will clear any misunderstandings.

Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage. Our friendly office manager will be happy to help you with filling out and filing your insurance claim in order to receive the most reimbursement from your insurance coverage.

Most insurance companies will respond within four to six weeks. Please call your insurance company if you haven’t received your insurance payment within that time frame. Monthly payment arrangements must be implemented prior to treatment. Your prompt remittance is appreciated.

HIPAA Compliance

Drs. Negar S. Tehrani is committed to the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The office has a HIPAA officer and conducts training on privacy matters for all of its employees. Patient consent is required in writing before releasing any records to anyone.

All business matters, financial and otherwise, relating to this office, and matters concerning employees, doctors, referring doctors, or their patients is regarded with respect and confidentiality.

Our office reviews confidentiality obligations with its employees and other agencies that may need or be exposed to patient records on a periodic basis to help ensure compliance. Our computer system is protected with an advanced gateway firewall and antiviral software. We proudly have implemented electronic medical records which are protected with the latest security systems and are more secure than traditional paper records.

We offer discrete services including special scheduling of appointments, private entry and exit, and a private waiting area if a high profile patient requests or requires it.