Patient Center
Before Your First Visit
Before visiting our office for the first time you may wish to fill out your new patient paperwork at home to save time in the office. Simply print at home, fill out, and bring the signed forms with you to your appointment.
Patient Forms
- New Patient Registration
- Authorization to Discuss Medical Care / Patient Account
- Consent to Treat/Receive Text Messages/Use Email
- Pain Policy
- Impacted Teeth
- Anesthesia
- Paresthesia
- Post Op
- Physician Referral Form
Your First Visit
Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Although surgery may be performed on the same day in some instances, it is not usually recommended and cannot be guaranteed in every case. Dr. Cardona-Rohena believes that you deserve the best treatment possible. In order to accomplish this goal, a thorough oral and facial evaluation is recommended prior to any surgical intervention. Even though your dentist or physician has diagnosed a particular problem, they have referred you to Dr. Cardona-Rohena out of concern for your well being. This referral usually requires a comprehensive exam including a review of your medical history and x-rays.
Please assist us by providing the following information at the time of your consultation:
- Your surgical referral slip and X-rays if applicable
- A list of medications which you presently take. NOTE: It is preferable to bring your medications with you so we can accurately record them in your surgical record with the proper names and dosages.
- If you have medical or dental insurance, bring the insurance cards. Your driver’s license or some type of photo ID. IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit.
- X-Rays and CT Scans
Note: There will be a cancellation fee of $50.00 without a 24 hour notice for consultations. Surgeries that cancel without a 24 hour notice will be charged a $100.00 cancellation fee.
X-Rays and CT Scans
If your dentist or physician has taken x-rays, you may request that they forward them to our office or bring them with you. Please be aware that x-rays taken at other offices may not be sufficient to properly evaluate you with respect to your oral and facial surgical needs. Additional films such as a panorex which reveals structures of the face, jaws, and teeth may be necessary. This special type of x-ray can be taken at our facility. Dr. Cardona-Rohena has found cone beam CT Scans are highly beneficial especially with dental implant patients giving her the ability to accurately place implants and reduce surgery time. She will explain the need for this imaging modality if needed and how it would be performed as well.
Insurance
A few things you might want to know about your insurance:
Dental insurance is a type of health insurance designed to pay a portion of the costs associated with dental care. Most dental insurance plans are a business arrangement between an insurance company and an employer. It is important to remember that reimbursement and benefit levels are based on carrier and employer business decisions, and not on an individual’s need for treatment.
Medical insurance is insurance against the risk of incurring medical expenses among individuals. Some, if not most, health care providers in the United States will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company does not pay. The insurance company pays out of network providers according to "reasonable and customary" charges, which may be less than the provider's usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider's standard charges. It generally costs the patient less to use an in-network provider.
Please make sure that you check with your dental and medical carriers that we are an in-network provider with them. We will check your insurance when you make your appointment with us as a courtesy but ultimately it is your responsibility to know your benefits and your eligibility as well.
Our commitment is to your health, regardless of what insurance you have!
Your Privacy
Your privacy is important to us. Review our privacy policy to learn when and how we use your protected health information. We have amended our policy recently as well.
