New Patient Information and Forms

If you’re new to our practice, we’d like to welcome you. Thanks for trusting us with your dental care. We find that the best outcomes come from building solid expectations on both the part of our office and with you, the patient. You can find information, answers to frequently asked questions, and required forms so we know all we need to know about you and so you know what to expect from Country Club Dentistry. Please download and complete all of the new patient forms here.

Emergency Care Policy

Emergency care is available after hours for patients of record. Please call our main line for assistance. If you are not a current patient, we will be happy to accommodate emergency dental cases during regular office hours.

Insurance Policy

We are happy to help you take advantage of your insurance. When you decide to schedule treatment, we will work together to develop your personalized dental plan (PDP). Once we’ve developed your PDP, we’ll talk to you about payment options.

You can pay us directly using traditional payment methods, or arrange for financing using one of the below options.

While we are working on your treatment, we’ll fill out your paperwork for the insurance company on your behalf. We’ll put in the proper codes that should help you maximize reimbursement based on the terms in your policy. We’ll then submit the claim for you either through mail or sending it electronically.

However there are some insurances (like Delta Dental of California), that only allow payment to be sent to the subscriber (you). If this is the case we will do our best to notify you in advance. Any claim not paid by your insurance will become your responsibility.

Reimbursement will then come directly to you. We encourage you to ask your insurance company what reimbursement you can expect for the treatment, but we caution that even if you get pre-approval, the reimbursement will be less than you expect. It may even be less than they initially said.

Convenient Payment Options

Paying for your dental work is easy with our hassle-free payment options. We accept all major credit cards, as well as your personal checks or cash. Third-party financing is available through CareCredit. Click here to go to their website for more information on their zero-percent financing or to apply.

Not every patient has the same financial situation. To help you get the care you need, we offer financing through GreenSky Patient Solutions. GreenSky can approve your application in just minutes so we can begin your dental work as soon as possible. GreenSky also offers fixed-rate options and deferred interest promotions to make financing your dental work a breeze.

Privacy Policy

Your privacy is very importance to us. You can view our updated privacy policy here.

Please Call:  We’re Here to Help

If you have any questions or concerns as a new or existing patient, we’d like to help. Please don’t hesitate to call us at (760) 832-7915.