For You

New Patient Forms

We look forward to seeing you in our state-of-the-art Fort Myers, Florida office. Save time at your appointment by printing and completing the following forms:

We Accept Most Major PPO Policies

Provide your insurance information before your appointment and we’ll make sure everything is ready to go before you walk in the door, avoiding surprises or unexpected fees.

No Insurance?
No Problem!

For our valued new patients with no insurance, we offer a first time appointment special for $115.00. This includes your regular dental cleaning, a full set of x-rays, and an exam by one of our doctors. This allows patients without insurance to save money while still getting the quality care they deserve. 

Financing Through
Care Credit

We are a Care Credit participant for those who prefer financing through a third party.

The CareCredit credit card makes it easy and affordable to receive the dental care you need. For more information visit or call 1.800.677.0718.