New Patient Forms

Congratulations and welcome to Masterpiece Smiles! Save time at your first appointment by downloading and completing the appropriate Patient Forms before you arrive. Remember to bring the forms with you on the day of your appointment. Simply click the link below, print and fill out the documents.

Insurance

Masterpiece Smiles accepts most major insurance plans. For a comprehensive list of qualified insurance plans and to see if your plan is covered, please call our insurance specialists.

Billing

We accept cash, check, credit or debit. For information concerning your bill, please contact our billing department.

CareCredit

Financing is Easy with CareCredit®. Get the care you want today. Masterpiece Smiles is pleased to offer financing to our patients through CareCredit® Healthcare Finance. This convenient financing option can be applied to any Masterpiece Smiles procedure.

ProDent

Masterpiece Smiles is proud to introduce a dental benefits package tailored to our dental family. Our patients are our focus. Individuals and families without current dental insurance qualify for this in-office dental benefits package. ProDent brings affordable dental care within convenient reach.

ProDent Benefits:

• Free Exams
• Free X-rays
• Free Cleanings Every 6 Months
• NO Pre-Existing Exclusions
• NO Missing Teeth Clauses
• NO Pre-Authorizations Required
• NO Claim Forms to File
• NO Waiting Periods for Treatment
• NO Annual Maximums

Annual Plan Type Premium:

• Individual $517
• Patient and Spouse $652
• Family $757

*$17 Copay per visit.
*ProDent dental benefits apply only to treatment at Masterpiece Smiles.