New Patient Forms to Make Your First Visit Simple and Easy
We want to ensure your first visit to our dental office is a success. By providing us with important information prior to your visit, you’ll save time when you arrive at the office and we’ll have an opportunity to get to know you and your dental history.
Please take a few moments to download, print, and fill out the forms below. Bring these forms to our office before or during your first visit so that we may enter all of your contact information, insurance information, and other important details about your dental history into our secure records system.
If you have any questions while filling out these forms, please don’t hesitate to reach out to one of our friendly and knowledgeable staff members. You can call us at 405-302-0100 Monday through Thursday from 9am to 5pm. We’ll walk you through the registration process and provide you with any information you need to complete the forms properly.
As a dentist accepting new patients in Northwest OKC, we know that you have your choice of dental professionals and we thank you for your interest in Monica Neely Dentistry. We work hard to ensure our patients have everything they need for a comfortable experience at our dental office. Patient health is our top priority and the more information we have about you, the better we’re able to provide appropriate treatment and recommendations related to your oral health. If you’re not sure if something is relevant to your oral health, please don’t hesitate to ask our staff and we’ll help clarify what information we need.
We look forward to getting to know you and helping you achieve a healthy-looking smile.
Please take a moment to fill out each form below and review the financial policies related to insurance-holding patients. If you don’t have insurance, please review the financial policy without insurance document below. If you need more detailed directions to our office, please review the overview map or close-up map below.
- Registration Form
- Medical History Form
- Financial Policy with Insurance
- Financial Policy without Insurance
- Overview Map
- Close-Up Map
Be sure to check with your insurance company to determine what services are covered prior to visiting our dental office. While we do accept many forms of insurance, we cannot verify all services prior to your visit. If you are concerned that your insurance plan may not cover a specific treatment or procedure, we encourage you to contact your insurance company.
If additional assistance is required, phone our office at 405-302-0100.