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NEW PATIENTS

STEP 1

STEP 2

STEP 3

Please upload a picture of FRONT and BACK of your dental insurance card, and then click 'Submit'



    Front of Dental Insurance Card:

    Back of Dental Insurance Card:

    *After submitting your insurance card you will be automatically directed to Ident.com to fill out your New Patient Forms. 
    SKIP, GO TO MEDICAL HISTORY
    Skip directly to Ident.com to fill out your New Patient Forms. 

    Example Front:

    Example Back:

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