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Extending
patient care through the Internet |
| WHAT
THIS SITE DOES....... |
| This
site allows you to enter your new or updated patient information and
have it forwarded to your dentist prior to your visit. It does not
retain information and thus you need to complete each page even if
you have been here before and are simply updating your information
as requested by your dental office. |
| WHAT
DO I NEED? |
| You
will need the following items or information before you begin: |
- Social Security Number of Patient and Insurance Subscriber
- If applicable insurance information (Insurance Company,
Group and Policy #, Employer, etc.) - Both Primary/Secondary
- Patient medical and dental history
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| WHERE
DO I GO TO ENTER MY INFORMATION? |
| If
you are ready to begin the process, then simply click on the link
to the right of this text >>>>>>>>
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| WHAT
IF MY DENTIST IS NOT LISTED? |
If your dentist is not currently listed here, please click on
the link below this text and it will allow you to complete a customer
referral form that will be forwarded to us. We will in turn send
them an e-mail letting them know of your request.
Until that time, it will not be possible for you to enter your
information here until that office becomes a member of this site.
Please feel free to contact your dentist and recommend us to them
or refer your doctor to www.dentalinformationdirect.com.
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