Forms, Policies, and Payment

We understand that along with quality dentistry, our patients expect excellent service and timely care. We have provided our Patient Forms, Policies, and Payment Information here to help expedite your check in process.

Patient Forms 
We encourage you to print the Patient Forms and complete them at home, prior to your appointment with Dr Barth. Please bring the forms with you on your appointment day. 

Please print and sign the New Patient Form, Financial Agreement, and HIPPA Policy. If you prefer to prepare your paperwork in our office please arrive about 15 minutes early so that we can keep your visit on time.

Insurance Plans Accepted
We currently accept plans from Assurant, 
​United Concordia, Cigna, and Aetna.
If you do not see your insurance carrier here, 
please contact us for more information.

Payment Options
Cash, Check, Visa, Mastercard, Discover, American Express

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Patient Forms and Policies

New Patient Adult Form

Financial Policy

New Patient Child Form

HIPPA Policy

Our friendly staff is here to assist you with a variety of dental services for your entire family.
Contact us to request your appointment!

Contact Us