Patient Forms

Doctor working on teethNew Smile Dental Clinic patients must complete the new patient registration form.  It is available in English and Spanish.  Download it, print it and bring it with you during your visit.

Pacientes nuevos de Smile Dental Clinics deben completar las formas de registro. Están disponibles en ingles y español. Descárguelo, imprímalo y tráigalo con usted a su visita.

 

New Patient Registration Form – English

New Patient Registration Form – Spanish

Payment Options

 

Smile Dental Clinics accepts most private insurance and AHCCCS. Although we do not generally offer financing options, we do work with CareCredit and LendingClub.

Please note these are third party providers, and Smile Dental Clinics has no input on your ability to receive financing for your desired procedure. That said, many of our customers have worked with these companies and have given us good reports about their experience.

To learn more about Lending Club Click Here.