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Patient Information

New Patient Forms
 

We are happy to make our new patient forms available for download online at your convenience.  To download, please click on the button to the right.

 

We kindly request that you bring these completed forms to your first visit or plan to arrive 15 minutes early so that you can complete them on site.  Thank you!

Dental Insurance

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Uptown Dentistry has in-network relationships with select (not all) PPO dental insurance plans from the PPO companies listed below.  We recommend contacting your dental insurance to verify current network status for your specific plan.  We are happy to file claims with your primary insurer on your behalf, and you are responsible for any remaining patient portions or non-covered procedures.  Providing us with your current insurance information in advance of your appointment helps us determine eligibility and coverage prior to your visit.  

  • Aetna

  • Assurant

  • BCBS Commercial PPO

  • Cigna DPPO Total

  • Connection

  • Delta Dental Premier

  • Humana

  • Metlife

  • Principal Financial

  • SunLife

  • United Healthcare

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