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Your First Step to a Healthy Smile: Patient Forms
As a courtesy to our patients, we will file your insurance claims for each visit. The fees we charge for services are based on the procedure that is to be done. Your policy may base its allowance on a fixed fee schedule which may or may not coincide with our usual fees.
You should be aware that different insurance companies and dental plans vary greatly in the types of available coverage. If you have any questions regarding your dental coverage, we encourage you to contact your insurance provider directly. We will be glad to file pre-determination of benefits with your dental insurance carrier before your treatment.
If you are unable to keep your appointment, we would appreciate at least 2 business-days notice so that your reserved time can be made available to another patient. Otherwise, a $65 per hour charge may be assessed to your account.
You should be aware that different insurance companies and dental plans vary greatly in the types of available coverage. If you have any questions regarding your dental coverage, we encourage you to contact your insurance provider directly. We will be glad to file pre-determination of benefits with your dental insurance carrier before your treatment.








Cancellation/Broken Appointment Policy
At Highland Family Dental, appointment time is reserved just for you. We don’t overbook, and with the exception of patients who call us with emergencies, we schedule each individual patient to have our undivided attention. Thus, each scheduled appointment reserves at least an hour of our doctor and staff’s time.If you are unable to keep your appointment, we would appreciate at least 2 business-days notice so that your reserved time can be made available to another patient. Otherwise, a $65 per hour charge may be assessed to your account.
