New Patients

Welcome to our office!

We are pleased that you have chosen our practice for your endodontic care. To make an appointment, please telephone our office at 252-480-6646. Prior to your appointment, please download and complete the following forms and bring them with you to the office.

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Patient Forms
Please print and fill out these forms so we can expedite your first visit:

• Patient Registration Form
• Endodontic Consent Form (PDF)
• Medical History Form

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

• Notice of Privacy Practices 2020
• Privacy Practices Acknowledgement 2020

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Financial Policies

Fees are due and payable when services are rendered. For your convenience we accept cash, checks, VISA and MasterCard.

Our office does not accept assignment of benefits from insurance companies. As a courtesy we will submit a claim to your insurance company for your reimbursement. Please bring your insurance card to your appointment.

For patients in need of financing assistance we offer Care Credit interest-free for 12 months for qualified applicants.  Patients can check their eligibility for Care Credit on the internet by logging in to www.carecredit.com.  If you have any questions regarding our financial policies or anticipated cost of treatment, please call our office. 

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