Parkview Dental, PLLC
Financial Agreement

We are concerned about your dental health and look forward to helping you with your dental care. Please remember that your dental insurance is your responsibility, but we can help. Regardless of what we might calculate as your dental benefit in dollars, we must stress the fact that you, the patient, are responsible for the total treatment fee. As a courtesy to you, we can accept assignment of benefit payments from most insurance companies.

Financial Options for your Treatment

1. Pay in full: on or before treatment day
5% savings for cash and/or check.

2. Prepayment: before work is started
Weekly, bi-weekly or monthly.

3. Care Credit: Healthcare Financing Program
No interest or low minimum monthly payments.
1-800-365-8295 or www.carecredit.com

4. 1/2 payment at first appointment
Balance to be paid, not to exceed 3 months.