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• Ameritas

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• Medicaid

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• Tricare

• BlueCross/Blue Shield

• MetLife

• Delta Dental

• Aetna

No insurance? It’s OK! 

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New patient forms

Release of records

Select your location.

Returning patient forms

Post-treatment information

If you recently had a treatment done, please click for more information.

You may qualify for our discounted fee program. Application below.

Once the PDF is open, right click and select Save As to download it to your computer.

Discounted Fee Application