Whether you're a new patient or current member of our family some of the information here may be of use to you. The standard forms we have in our office are available for download with the links below. If you're a new patient feel free to download them and print them out prior to your office visit. You can fill them out at your leisure at home and bring them in on your first visit.
If you're a current patient and need to update your insurance, address or other information please feel free to take a moment and do it using these forms. They can be mailed in or just dropped off at your next visit.
As always, if you have any questions, just give us a call at: 517-676-3770, or contact us online.
Please Note all forms are in PDF format.
We request payment at the time of service, unless other arrangements have been made in advance.
We accept cash, checks, Mastercard, Visa, and Discover.
We participate with Delta Dental, Blue Cross Blue Shield and Cigna. We accept most other dental insurances, including Aetna, Companion Life, Great-West, Guardian, Jefferson Pilot, Principal Financial, SecureOne, SIHO, Weyco and many others. If you call us with your dental insurance information, we will be happy to determine what your plan will cover.
We also except CareCredit which is a healthcare card which is eligible for no interest and extended payment plans. You can contact them at 1-800-365-8295 or visit their website for more information.
We understand that circumstances arise in individuals lives that preclude keeping their time commitments, such as sudden illness, transportation problems, employer demands, etc. While we can be sympathetic about these events, we cannot take financial responsibility for them. We try very
hard to keep our fees reasonable, and unfilled appointments simply raise the cost of dental care for everyone. It is our office policy not to charge for the first missed appointment, however in the future, if an appointment is failed or is canceled with less than 24 business hours notice, and we are unable to fill your appointment, you may be charged $25.00. We will try our best to fill the appointment, the more notice we are given the better chance we will have filling the
appointment time. With three failed or canceled appointments per family within 18 months, you will be dismissed from our practice.
You may obtain your records and x-rays for a fee of $25.00.
Please let me know how else I can help.
Mason Family Dental welcomes you.
We know you have many choices when it comes to your dental care provider. We're happy that you've chosen to join our family.
As a new patient you're most likely wondering what your first visit will be like. Not to worry, we can provide you with a nice summary of that first visit.
Take a moment and click here you'll have a better understanding of our office and procedures.
Some important and informative links: