Patient Forms
Save time spent in the office & complete the medical history form ahead of time!
- New Patient Registration
- New Patient Medical History
- New Patient Dental History
- New Patient Practice Policies
- Notice of Privacy Practices
- HIPAA Acknowledgement
Please Contact Us if you have questions!
Interested in our Special Offers?
Click here to learn about our exciting patient specials!
Alpine Care – Alpine Dental’s In-House Premier Dental Plan
Enroll Today!
It’s a discounted fee schedule for most services that is only good at Alpine Dental. You save on everything from cleanings and fillings to cosmetic procedures and crowns!
- All Health Conditions Accepted!
- You Cannot Be Denied Coverage!
- No Deductibles!
- No Health Questions!
- You cannot be Singled Out For Rate Increases or Cancellations!
Now you can join our low-cost dental plan for a nominal membership fee. Our coverage entitles you to preventative dental care at no cost! Corrective Services are available for small co-payments that are far less than the usual customary fees. Our professional staff is qualified to care for all your dental needs!
Alpine Care: Not Available for Periodontal Patients
- Individual: $399 each adult (for one year)
- 2 cleanings
- 2 exams
- A full set of x-rays
- 10% – 15% discount on all other dental services and procedures
- Children: $266 each child (for one year) – Ages 3-5
- 2 Cleanings
- 2 Exams
- 10% – 15% discount on all other dental services and procedures
- Children: $315 each child (for one year) – Ages 6-11
- 2 Cleanings
- 2 Exams
- 2 Bitewing X-Rays
- 10% – 15% discount on all other dental services and procedures
- Children: $348 each child (for one year) – Ages 12-17
- 2 Cleanings
- 2 Exams
- 4 Bitewing X-Rays… (or) Full Mouth X-Rays… (or) Panoramic X-Ray
- 10% – 15% discount on all other dental services and procedures
For ADULTS requiring 3 cleanings per year, apply 15% discount to $115
For CHILDREN requiring 3 cleanings per year, apply 15% discount to $85
For more detail about Alpine Care, click here.
Interested in joining? Contact us now to find out how!
Financing Available through Care Credit.