Welcome to Citrus Dental!
Please complete the following forms and either email them to us at firstname.lastname@example.org, bring them to your appointment, or mail them to:
Citrus Dental of Inverness, 2231 Hwy 44 W, Unit 101, Inverness, Florida 34453
The Notice of Privacy Practices is yours to keep. If you have children who may be in the office without a parent present, please read and sign the Parental Permission form.
- New Patient
- Medical History
- Notice of Privacy Practices
- Parental Permission
- Receipt of Notice of Privacy Practices
Your scheduled appointment time has been reserved specifically for you.
We request a 24-hour notice if you need to cancel your appointment.
We are aware that unforeseen events sometimes require missing an appointment, and appreciate your cooperation.
Our office is committed to helping you maximize your insurance benefits. Because insurance policies vary, we can only estimate your coverage in good faith but cannot guarantee coverage due to the complexities of insurance contracts. Your estimated patient portion must be paid at the time of service. As a service to our patients, we will bill insurance companies for services.