Patient Information

We strive to provide our patients not only the best dental care but also the best clerical support staff. Patient forms are a necessary evil in the world of healthcare. We make an effort to be thorough in collecting information, but we try not to overburden our patients with paperwork. Maintaining accurate contact information for the patient, spouse, and/or guardian as well as accurate data related to your dental benefits streamlines the tasks necessary for filing claims, billing, and communicating with the families we treat. We try to keep our files up to date, but we ask you to help too, by keeping us up to date on any changes in contact and insurance information. If you have a secondary insurance, please let us know so we can provide an additional form to gather that data to add to your file.

We gather each patient’s health history and ask that you update this annually or more often if health changes occur since your last visit. It is very important that our providers are knowledgeable of any health issues that may affect diagnosis or treatment options. Please read and acknowledge our financial policies so you will know your fiscal responsibilities to Blue Ridge Family Dentistry. Finally, there is a section regarding HIPAA policies. We maintain your personal health privacy and share information necessary to file claims, prescribe medication, and/or discuss your health or billing issues with persons you have indicated on the form we provide. Please remember, if someone other than you handles your billing or assists with your healthcare, we will not be able to speak to them unless you have given us the authority to do so.