Convenient Payment Options

Our patients’ comfort and satisfaction are the top priorities at our office. We make sure you have all the conveniences you deserve while under our care, even when it comes to payment and financial policies. We understand some payment options may not work for some patients’ financial situations and preferences, so we provide different options from which you can chose. Belmont Dental Care will provide quality services that work with your budget.

New Patient Forms

Is this your first time making an appointment with us? If it is, please download these new patient forms, fill them out, and bring them with you when you come to our office. The information you provide helps us determine exactly what kind of services you require, and allows us to make your first visit as comfortable as possible. If you have any questions feel free to call us at this number (480) 609-0050. Your Scottsdale Dentist will give you the dental service you deserve.

PATIENT INFORMATION FORM 2012

Belmont Financial Policy and HIPPA Dec 2011

Medical History Exam

Right-click on each link and choose “Save as…” to save the forms on your own computer.