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Forms / Resources

Forms

If possible, please print these forms out and bring them with you. The forms are also available at our office. The Patient Registration form is web-fillable, as long as you are using an updated version of Adobe Reader.

NOTICE: Please wait to sign any of the forms until at our office.

Patient Registration (Web Fillable)

Financial Policy Form

Complete Notice of Privacy Practices

Credit Card Authorization Form

Financial Information

Here at Tyler Oral & Facial, we offer many ways to pay for your treatment. We accept all major credit cards (Visa, MasterCard, American Express, Discover) as well as offer 0% interest, flexible financing plans to those who qualify. We also accept Medicare and Medicaid.


CareCredit
, a part of GE Capital, offers healthcare financing for consumers through a network of over 150,000 providers. Founded in 1987, CareCredit was initially offered to doctors to help their patients pay for new dental implant technology. Continued advancements in technology, and procedures that are often not covered or fully covered by insurance, have created new choices for care, increasing the demand for financing options. CareCredit is a healthcare credit card that can be used as a payment option for certain expenses not covered by insurance or to bridge situations when desired care exceeds insurance coverage.

More information on CareCredit, helpful calculators, and more can be found at www.carecredit.com.

To apply for CareCredit, please click here.

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