FOR PARENTS

We accept most insurances:

Delta Dental Premiere, Dental Network of America, Guardian, Metlife, Assurant, Careington, United Concordia, Principal, Ameritas, Humana , Cigna DPPO , Virginia Medicaid, United Health Care

Patient Forms

Please download the New Patient forms and email them to us at [email protected] or fax to 540.707.9240 prior to your appointment date. If you are unable to fill out the forms, please arrive 30 minutes early to complete the paperwork. We look forward to seeing you!

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.


Office Policies

Scheduling

Office visits are by appointment only. We always make time for dental emergencies. We make every effort to see your child at the scheduled appointment time and we ask you to afford us the same courtesy. Schools consider dental appointments to be an excused absence and we can provide a doctor's letter for the teacher upon request.

Maintaining Happy Relationships

Sometimes, despite our best efforts, dental work cannont be completed as planned. We understand that it may be frustrating and inconvenient to have to schedule another visit and that may require you to change other plans. But we ask that you respect our policy to not restrain or cause distress to a child in order to complete non-emergency dental work.

Cancellations

Culpeper Kids Dentistry is a small office that sees one patient at at time, and your child's appointment is reserved specifically for him or her. We do understand that sickness and emergencies may come up and that you need to cancel an appointment. However, we do ask that you give us notice at least 48 hours in advance if you cannot make it to your appointment. We will do our best to reschedule your child's appointment to a more convenient time.

Billing and Insurance

Please contact our office to verify acceptance of your dental plan. If you have provided all of your insurance information by the day of the appointment, we will be happy to file your insurance claims for you. Our office provides you with a good faith estimate of your payment portion but cannot guarantee coverage by the insurance company. You are responsible for any balance in your account after 60 days. When a dental claim is unpaid due to a change in insurance, the patient is responsible for the unpaid balance. Please inform us of any insurance changes before your scheduled appointment.

Payment Options

We accept cash, check, credit cards and CareCredit. Our staff is there for you if you have any questions.