PATIENT FORMS
We invite you to download, print, and complete our forms prior to your appointment. This will speed up your appointment time and make the need to show up 30 minutes early to your appointment not needed. Please remember to list all medications/allergies.
If you have taken pre-medication antibiotics prior to a dental visit in the recent past, please call and confirm with us prior to your next appointment.
Paper Version Medical History & Forms
Patient Information Form
Financial Policy
HIPAA Privacy
Online Version Medical History & Forms
Click Here for Online Forms
We are contracted with the following PPO insurances. Please call if you have any questions about your dental insurance plan or benefits.
- Aetna
- Ameritas
- Anthem Blue Cross
- Assurant
- Blue Shield
- Cigna
- Delta Dental
- Dental Benefit Providers
- Dentemax
- First Dental Health
- Guardian
- Humana
- Metlife
- Principal Dental Plan
- United Concordia
- United Healthcare
Let us submit your claims
We submit all insurance claims for you, help you keep track of your benefits, and submit pre-authorizations to ensure there are no surprises when it comes to your insurance claims. A variety of payment plans are available, including 12-month interest-free financing for more extensive treatment. We accept check, cash, and major credit cards. We also accept all PPO plans.
Your first visit to JBS Dental in Fountain Valley familiarizes you with our dentist and staff. We understand that all patients are unique and require specific needs.
Our Practice's Mission:
To fulfill our mission of providing quality dental care to you and your family, we are committed to:
- Staying up to date with latest techniques and equipment.
- Ensuring a comfortable, relaxing environment.
- Exceeding your expectations with our professionalism.
What Every Patient Can Expect
At our practice, every patient can expect to be treated with prompt service that meets their specified appointment time. Every patient can also expect a comfortable experience. We take pride in providing quality, efficient, and personalized dental care.