Patient Information

Forms

Your first visit to Virdi Dental will establish the foundation for our relationship. Bring any questions you have, any information you have for previous dental or medical treatment, including dates of surgeries, medications, and treatment plans that have yet to be completed. During our first visit, we will take time to get to know each other and discuss the information you brought with you, in addition to other background history. Filling out your medical history thoroughly and honestly is very important to providing comprehensive care. Save time at your first visit by downloading the forms here, filling them out, and bringing them to your appointment.

• Patient Medical History Form
• New Patient Information
• Consent for Use and Disclosure of Health Information
• Financial Policy
• Notice of Privacy Practices
• Acknowledgement of Notice of Privacy Practices

Your first exam will include: charting of your tooth and gums, a complete series of x-rays, a panoramic x-ray if needed, diagnosis of oral health, and a treatment plan. A cleaning may or may not be included at this appointment.

Office Policies

At Virdi Dental, we are dedicated to providing quality, comfortable, compassionate care in a relaxing environment. We take pride in our commitments to our patients, our team members, and your oral health. We strive to:

• provide excellence in all aspects of every appointment
• exceed your expectations
• listen to your concerns and answer any questions you have
• continuously seek out professional resources to provide you with up-to-date care

Virdi Dental complies with applicable Federal civil rights and does not discriminate, exclude, or treat anyone differently on the basis of race, ethnicity, age, color, national origin, language, ability, gender orientation, or sexual orientation.

Insurance and Payments

We are a Delta Dental Premier Provider and a member of the extensive United HealthCare network. In addition, our office accepts most major dental insurance providers. If you have questions about your policy, call our office and a member of our team will be happy to help you.