Cosmetic Dental Solutions - New Patient Info - Dr. Chris Sholota
If you are a new patient to our office, the files below contain our New Patient Forms. Please fill out the ELECTRONIC Medical & Dental Forms online. Thank you and please call our office if you have any questions at all.
Please fill out this form online, securely. This can be done on any computer, smartphone, or browser. Both you and our dental office will receive a confirmation email once you've answered all the questions. You will need to register first and a link will be sent to you and then you can start the forms.
Electronic Medical & Dental Forms
For your convenience, we accept cash, personal checks, money orders and major credit cards. Payment is expected at the time services are performed. When more extensive dental care is necessary, financial arrangements can be made with our office.
As a service to our patients, our practice accepts most dental insurance programs, including non-managed care, indemnity (traditional) and PPO out-of-network. We are not part of any managed care network. Our accounting staff will prepare all the necessary forms for your dental benefits. However, we remind you that your specific policy is an agreement between you and your insurance company. Please keep in mind that you are responsible for your total obligation should your insurance benefits result in less coverage than anticipated. Our staff will gladly submit a pre-treatment estimate to your insurance company so that you will know what your benefits will be.
The fees charged for services rendered to those who are insured are the usual and customary fees charged to all our patients for similar services. Your policy may base its allowances on a fixed fee schedule, which may or may not coincide with our usual fees. You should be aware that different insurance companies vary greatly in the types of coverage available. Also, some companies take care of claims promptly while others delay payment for several months.
Chris Sholota- Your Johns Creek Dentist