We are elated to have you with us! Please take the time to acquaint yourself with our office policies, and your
financial obligations. Should you have any questions regarding this, we would be happy to answer them.
Our office will call, text and email 14 days, 7 days, and 24 hours prior to your appointment to remind you of your
scheduled visit. We do this as a courtesy for our patients. A lack of reminder from our office does not indicate
your appointment has been cancelled. If you believe you have an appointment with us, but have not received an
advanced reminder, kindly contact us and we will be happy to confirm the date and time.
If you are unable to keep your appointment time, it is your responsibility to notify our office 24 hours in advance
to avoid cancellation charges. If a patient No Shows, Arrives Late, or Cancels their appointment without 24 hours
notice a $50 fee for cleaning appointment and $100 fee for doctor appointment will be applied to the patient
account. All cancellations must be reported via phone call or email. Cancellations left on the voicemail after
business hours is not considered as a 24-hour notice.
We understand that sometimes unexpected situations and emergencies arise. We will work with you during such
circumstances. Kindly keep in mind that this policy is in place to ensure each patient’s time, as well as our office
time is valued and used efficiently to accommodate all of our patients.
When it comes to emergencies, it is our goal to get you scheduled as quickly as possible. We ask that you be
flexible with your time which allows us to get you in the office more urgently. Emergency time is available during
our regular office hours. Dr. Linty John-Varghese can be reached at 937-903-0835 after office hours to established
Copy of Records
We will gladly provide you with a copy of your dental records, and or X-ray’s. Under HIPPA and practice guidelines,
patients must sign a records release form (that we can provide) indicating where the records need to be sent. Giving
our office permission to send such records electronically. If you would like a hard copy of records, there will be a
$25.00 fee. Please allow 2 to 5 business days for records to be sent.
As a courtesy we will file all claims with your dental insurance. Patients that have Superior, Delta Dental or
Anthem Federal plans will be required to pay for their appointments in full due to the Insurance Companies paying
the patient. Payment will be due at the time of service.
This program is for patients who do NOT have dental insurance. Expires after 12 months, with options to renew after.
It is the patient’s responsibility to schedule their treatment needs within the 12 months, to maximize benefits
included in this program.
Scheduling Dental Appointments
All dental procedures longer than 90 minutes, will require a 50% deposit to reserve your appointment. Cancellations
of these longer appointments in less than 24 hours will result in $100 cancellation fee. Our time is valuable, and
it is difficult to fill these appointments at the last minute.