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PATIENT FORMS

Click to download PDF. Please bring the completed forms to your next appointment.
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MOST ACCEPTED INSURANCES

Aetna Dental (Traditional and PPO)
Ameri Health Dental
Ameritas Dental
Assurant
Cigna Dental (Traditional and PPO)
Dentemax
Delta Dental (Premier, Advantage, and PPO,
if out-of-Network benefits are included)
Guardian Dental
Heavy & General Laborers
Blue Cross Blue Shield (Traditional)
MetLife Dental
Oxford Dental
Self-Insured Dental Services
United Health Care Dental


Please contact us to verify your insurance.

© 2023 by Clifford Choong Lee, DMD
Icons by th Noun Project, Edwin PM, and rivercon

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